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Skill:Medicare Utilization Management

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1–2 jobs· newest first

Appeals Nurse ConsultantNew
Lifelancer · Remote, US+1 more
$67K–$143KRemote · Full-time
Appeals Nurse ConsultantNew
CVS Health · Remote, US
$67K–$143KRemote · Full-time

+10K new in the last hour

Appeals Nurse Consultant

Lifelancer · Posted Nov 13, 2026

Remote, United States +1 more
Remote
Full-time
$67K–$143K per year
3–5 years

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This is a full‑time remote position working from home anywhere in the US, managing PAR Provider Post Service payment disputes and appeals for Medicare.

Locations (2)

Hartford, Connecticut, United States
United States

Compensation

The typical pay range for this role is: $66,575.00 - $142,576.00

Responsibilities

Request and research submitted provider clinical information to support case review and determination processes.
Review documentation to identify relevant clinical details and apply CMS guidelines, regulatory requirements, and applicable supplemental policies.
Based on clinical review findings, prepare a comprehensive nurse summary for medical director evaluation or finalize appeal determinations in accordance with pre‑approved workflows.
Navigate and manage multiple computer systems and applications to ensure timely, accurate, and compliant processing of cases.
Work independently with a high degree of self‑motivation while contributing to teamwork and collaboration in a virtual environment.

Requirements

Registered Nurse - associate’s degree or Diploma RN required, BSN preferred
Nice to have: 1+ years in Medicare Utilization Management
Nice to have: Managed Care experience
Nice to have: Appeals experience
Nice to have: coding experience

Skills

Registered Nurse clinical/hospital nursing experience Medicare Utilization Management case review prior authorization coding

Benefits

medical
dental
vision
paid time off
retirement savings options

See full job description

Appeals Nurse Consultant

CVS Health · Posted Nov 10, 2026

Remote, United States
Remote
Full-time
$67K–$143K per year
3–5 years

Apply with RefersoAI Apply on careers page

Full‑time remote Medicare PAR Provider Appeals Nurse Consultant managing payment disputes and appeals.

Compensation

$66,575.00 - $142,576.00

Responsibilities

Request and research submitted provider clinical information to support case review and determination processes.
Review documentation to identify relevant clinical details and apply CMS guidelines, regulatory requirements, and applicable supplemental policies.
Prepare a comprehensive nurse summary for medical director evaluation or finalize appeal determinations in accordance with pre‑approved workflows.
Navigate and manage multiple computer systems and applications to ensure timely, accurate, and compliant processing of cases.
Work independently with a high degree of self‑motivation while contributing to teamwork and collaboration in a virtual environment.

Requirements

Registered Nurse - associate’s degree or Diploma RN required, BSN preferred
Nice to have: 1+ years in Medicare Utilization Management
Nice to have: coding experience
Nice to have: pre‑authorization experience

Skills

Registered Nurse clinical/hospital nursing experience

Medicare Utilization Management

pre‑authorization

Benefits

medical
dental
vision coverage
paid time off
retirement savings options

See full job description