State Licensed Clinical Appeals Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025
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Job Description:
A company is looking for a Clinical Appeals Nurse to support
patients and healthcare providers by evaluating appeals and
disputes.
Key Responsibilities:
Analyze medical records and case files to produce objective
summaries for dispute resolution
Make evidence-based decisions in accordance with legal statutes and
clinical standards
Respond to issues raised by patients and healthcare providers
involved in appeals
Required Qualifications:
Associate's degree or higher in a healthcare-related field from an
accredited institution
LPN or RN License
Minimum of three years' experience in medical appeals or clinical
review
Background in Nursing, Physical Therapy, Occupational Therapy, or
Respiratory Therapy
Possession of a coding certification is a plus
Keywords: VirtualVocations, Carlsbad , State Licensed Clinical Appeals Nurse, Healthcare , Vista, California
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