Illinois Wisconsin Licensed Review Nurse
A company is looking for a Medical Claim Review Nurse (RN) to work remotely in Illinois and Wisconsin. Key Responsibilities Conducts clinical reviews of medical claims to ensure medical necessity and accurate billing Identifies quality of care issues and assists with complex claim reviews Documents findings and provides clinical support for payment decision modifications Required Qualifications, Training, and Education Graduate from an Accredited School of Nursing Minimum 3 years of clinical nursing experience At least 1 year of experience in Utilization Review and/or Medical Claims Review Active, unrestricted State Registered Nursing (RN) license in good standing Familiarity with state and federal regulations
A company is looking for a Medical Claim Review Nurse (RN) to work remotely in Illinois and Wisconsin.
Key Responsibilities
Conducts clinical reviews of medical claims to ensure medical necessity and accurate billing
Identifies quality of care issues and assists with complex claim reviews
Documents findings and provides clinical support for payment decision modifications
Required Qualifications, Training, and Education
Graduate from an Accredited School of Nursing
Minimum 3 years of clinical nursing experience
At least 1 year of experience in Utilization Review and/or Medical Claims Review
Active, unrestricted State Registered Nursing (RN) license in good standing
Familiarity with state and federal regulations
