Medicare Appeals RN — Remote Medical Review Specialist

WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and CMS-denial redeterminations. You will collaborate with Appeals Examiners to ensure medical necessity is demonstrated and guidelines are followed. The role requires an active RN license (state of practice) and 1+ year of clinical experience, with strong communication and detail orientation. Remote-friendly with eligibility to work in designated states.