Florida Licensed Medical Review Nurse
A company is looking for a Medical Review Nurse RN.
Key Responsibilities:
Review and authorize referral/authorization and clinical form requests based on established criteria
Collaborate with medical directors and other departments to determine benefit coverage and medical necessity
Document all prior authorization requests and maintain communication with providers
Required Qualifications and Education:
Active, unrestricted Florida State Registered Nurse (RN) license
At least two (2) years of clinical experience
Previous experience in Medicare or Managed Care, including medical review and prior authorization
Familiarity with coding systems such as ICD-10, CPT-4, and HCPC
Experience with MS Word, Excel, and PowerPoint
A company is looking for a Medical Review Nurse RN.
Key Responsibilities:
Review and authorize referral/authorization and clinical form requests based on established criteria
Collaborate with medical directors and other departments to determine benefit coverage and medical necessity
Document all prior authorization requests and maintain communication with providers
Required Qualifications and Education:
Active, unrestricted Florida State Registered Nurse (RN) license
At least two (2) years of clinical experience
Previous experience in Medicare or Managed Care, including medical review and prior authorization
Familiarity with coding systems such as ICD-10, CPT-4, and HCPC
Experience with MS Word, Excel, and PowerPoint