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Registered Nurse Medical Claims Review
A company is looking for a Registered Nurse RN Medical Claims Review Healthcare Compact License. Key Responsibilities Perform retrospective authorization reviews according to guidelines within a specific timeframe Determine medical necessity of requests by applying appropriate medical criteria and guidelines Review, document, and communicate all Medical Claims Review activities and outcomes Required Qualifications Current unrestricted RN license in the state of residency (compact license preferred) 2+ years of experience in managed care, Utilization Review, Case Management, or 5+ years nursing experience Proficient in PC software skills including Microsoft Word, Excel, and Outlook
A company is looking for a Registered Nurse RN Medical Claims Review Healthcare Compact License.
Key Responsibilities
Perform retrospective authorization reviews according to guidelines within a specific timeframe
Determine medical necessity of requests by applying appropriate medical criteria and guidelines
Review, document, and communicate all Medical Claims Review activities and outcomes
Required Qualifications
Current unrestricted RN license in the state of residency (compact license preferred)
2+ years of experience in managed care, Utilization Review, Case Management, or 5+ years nursing experience
Proficient in PC software skills including Microsoft Word, Excel, and Outlook
