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

Feb 18, 2025 - 17:48

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