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Indiana Licensed Clinical Reviewer
A company is looking for a Clinical Reviewer. Key Responsibilities Review medical records for accuracy and compliance with contract requirements and regulatory standards Manage daily workload and adjust schedules to meet departmental demands Serve as a liaison for customer service issues and maintain professional relationships with internal and external stakeholders Required Qualifications Associate or Bachelor's degree in nursing from an accredited institution Active unrestricted LPN or RN license in Indiana or a Compact clinical license 5+ years of clinical experience in an acute, behavioral health, or med-surgical environment 2+ years of experience in Utilization Review/Management or Prior Authorization Knowledge of medical necessity review and InterQual criteria or Milliman Care Guidelines
A company is looking for a Clinical Reviewer.
Key Responsibilities
Review medical records for accuracy and compliance with contract requirements and regulatory standards
Manage daily workload and adjust schedules to meet departmental demands
Serve as a liaison for customer service issues and maintain professional relationships with internal and external stakeholders
Required Qualifications
Associate or Bachelor's degree in nursing from an accredited institution
Active unrestricted LPN or RN license in Indiana or a Compact clinical license
5+ years of clinical experience in an acute, behavioral health, or med-surgical environment
2+ years of experience in Utilization Review/Management or Prior Authorization
Knowledge of medical necessity review and InterQual criteria or Milliman Care Guidelines