Licensed Clinical Claims Nurse

A company is looking for a Clinical Claims Nurse (Healthcare Provider). Key Responsibilities: Analyze medical records and case files to produce objective summaries for dispute resolution Exercise independent judgment to make evidence-based decisions in compliance with regulations and standards Conduct detailed research to support accurate decision-making and stay informed of healthcare developments Required Qualifications: Associate's degree or higher in a healthcare-related field from an accredited institution LPN or RN License Minimum of three years' experience in medical appeals or related healthcare roles Background in Nursing, Physical Therapy, Occupational Therapy, or Respiratory Therapy Possession of a coding certification is a plus

May 15, 2025 - 00:26

A company is looking for a Clinical Claims Nurse (Healthcare Provider). Key Responsibilities: Analyze medical records and case files to produce objective summaries for dispute resolution Exercise independent judgment to make evidence-based decisions in compliance with regulations and standards Conduct detailed research to support accurate decision-making and stay informed of healthcare developments Required Qualifications: Associate's degree or higher in a healthcare-related field from an accredited institution LPN or RN License Minimum of three years' experience in medical appeals or related healthcare roles Background in Nursing, Physical Therapy, Occupational Therapy, or Respiratory Therapy Possession of a coding certification is a plus