Appeals Nurse (LPN)

A-Line staffing is hiring an Appeals Nurse (LPN) in West Des Moines Iowa!! If interested APPLY NOW to Chris Meyer for IMMEDIATE consideration!! Appeals Nurse Details: Location: Remote work with potential to move onsite to West Des Moines, IA after about 6 months – must live in Iowa and have an active Iowa Nursing License Schedule: Monday-Friday 8:00am-5:00pm Appeals Nurse Compensation The pay for this position can vary from $26-$28 per hour depending on years of experience Benefits are available to full-time employees after 90 days of employment A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates Appeals Nurse Qualifications : Active LPN license in the state of Iowa Must reside in Iowa (Able to commute to West Des Moines if needed) 3+ years of LPN experience Required 2+ years of Experience with Utilization Review, Appeals, Denials, or authorizations highly preferred Must have solid computer skills Appeals Nurse Responsibilities : Review and process Iowa Medicaid Member Appeals Member appeal requests are received and assigned by the team lead, the appeals nurse is responsible for working the appeal start to finish. Outreach attempts are made to member/provider. A clinical review is completed and case sent to specialty review/MD. Appeals nurse will write determination letters and close the case. 30 calendar days to complete standard cases and 3 business days to acknowledge receipt of the case. This team handles all Iowa Medicaid appeals except behavioral health Appeals Nurse Preferred Qualifications : Writing Appeal/Authorization outcome letters Previous managed care or MCO experience is highly preferred If interested APPLY NOW to Chris Meyer for IMMEDIATE consideration!! Appeals Nurse Responsibilities: Review and process Iowa Medicaid Member Appeals Member appeal requests are received and assigned by the team lead, the appeals nurse is responsible for working the appeal start to finish. Outreach attempts are made to member/provider. A clinical review is completed and case sent to specialty review/MD. Appeals nurse will write determination letters and close the case. 30 calendar days to complete standard cases and 3 business days to acknowledge receipt of the case. This team handles all Iowa Medicaid appeals except behavioral health