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Illinois and Wisconsin RN Claim Reviewer
A company is looking for a Medical Claim Review Nurse (RN) Remote IL & WI. Key Responsibilities Perform clinical reviews of medical claims and appeals to ensure medical necessity and accurate billing Document clinical review summaries and audit findings in the database Provide clinical support and training for Utilization Management and assist with complex claim reviews Required Qualifications Graduate from an Accredited School of Nursing Minimum 3 years of clinical nursing experience Minimum 1 year of Utilization Review and/or Medical Claims Review experience Active, unrestricted State Registered Nursing (RN) license in good standing Bachelor's Degree in Nursing or Health Related Field preferred
A company is looking for a Medical Claim Review Nurse (RN) Remote IL & WI.
Key Responsibilities
Perform clinical reviews of medical claims and appeals to ensure medical necessity and accurate billing
Document clinical review summaries and audit findings in the database
Provide clinical support and training for Utilization Management and assist with complex claim reviews
Required Qualifications
Graduate from an Accredited School of Nursing
Minimum 3 years of clinical nursing experience
Minimum 1 year of Utilization Review and/or Medical Claims Review experience
Active, unrestricted State Registered Nursing (RN) license in good standing
Bachelor's Degree in Nursing or Health Related Field preferred