Appeals Nurse Consultant

Role Overview

• Responsible for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products
• Ensure timely, customer focused response to appeals, complaints and grievance
• Identify trends and emerging issues and report and recommend solutions
• Review and resolution of clinical documentation, clinical complaints and appeals

Requirements

• Experience in reading or researching benefit language
• Excellent verbal and written communication skills
• Excellent customer service skills
• 3-5 years of clinical experience required
• RN with current unrestricted state licensure required

Benefits

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access