Medicare Clinical Appeals RN ** 100% Remote for California Residents **

Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally, as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward.

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Medicare Clinical Appeals RN. *** Candidate must be authorized to work in USA without requiring sponsorship *** *** Location: Rancho Cordova, CA (100% Remote acceptable) *** Duration: 5 months contract w/ possible extension or conversion to FTE role Notes: Work hours: 08:00am – 05:00pm PT or 08:30am – 05:30pm PT. 100% remote for California residents.

The Medicare Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either preservice, post service or claim denial. In this role you will be responsible for performing first level appeal reviews for members utilizing the National Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, pharmacy policies and nationally recognized sources such as MCG, NCCN, and ACOG. Reviews may also be performed for medical necessity, non-covered benefits and to meet the criteria for the coding billed.