Idaho

Clinical Appeals Nurse

Idaho(9 days ago)

HybridFull TimeMedior$73,321 - $102,650Nursing/Clinical Services
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About this role

Blue Cross of Idaho is hiring a Clinical Appeals Nurse to review and manage clinical appeals for various product lines, ensuring timely resolutions and adherence to policy and coverage criteria. The role involves case review, collaboration, and process improvement in a flexible work environment.

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Required Skills

  • Clinical Criteria
  • Medical Policy
  • Claim Review
  • Utilization Management
  • Medicare Guidance
  • Electronic Medical Records
  • Critical Thinking
  • Communication
  • Collaboration
Idaho

About Idaho

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