Clinical Appeals RN

Medasource is a leading consulting and professional services firm supporting organizations across the healthcare ecosystem – including Life Sciences, RCM/Payers, Technology, Government and Nursing & Allied Health. Recognized for our commitment to our employees, consultants, and the communities we serve, we deliver solutions that drive meaningful progress across healthcare. With a nationwide footprint of 33 offices and 1,900+ active consultant placements across 120+ clients who are actively engaging Medasource talent, we continue to expand our impact as we advance the future of healthcare, one client at a time.

Position: Clinical Appeals Nurse (Medicare) Client: Health Insurance Client Location: 100% Remote (EST Hours) Start Date: ASAP

Review and evaluate Medicare appeals cases (pre-service and post-service) Conduct clinical documentation review and apply medical necessity criteria Draft appeal determinations using standardized templates Ensure complete and accurate documentation, including attachments Manage case workload aligned to productivity expectations (~5/day) Collaborate with internal teams and perform required outreach as needed Utilize AI-assisted tools while maintaining clinical judgment