Nurse Appeals at Elevance Health

This role enables associates to work virtually full-time, with the exception of required in-person training sessions. Candidates not within a reasonable commuting distance from the posting location(s) in Indiana will not be considered unless an accommodation is granted.

Requires a HS diploma or equivalent and a minimum of 2 years of experience in a managed care healthcare setting, or equivalent combination of education and experience. A current active unrestricted RN license to practice in Indiana is required.

Preferred qualifications include AS or BS in Nursing, 3 years of clinical experience as an RN, experience reviewing medical records and processing appeals in managed care, researching Medicaid/Medicare guidelines, and reviewing claims with CPT/ICD codes.

This information is not specified in the job description.

Strong candidates will have an active RN license in Indiana, managed care experience, and preferred skills like clinical nursing background, appeals processing, knowledge of Medicare/Medicaid guidelines, and claims review with CPT/ICD codes.