Clinical Benefits Support RN Specialist

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Tue, Sep 12, 2023

This job expires in: 20 days

Job Category: Customer Service

Remote Level: 100% Remote

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Job Summary

A company is looking for a Clinical Benefits Support RN Specialist to evaluate medical eligibility for benefits enrollment and support community-based services for individuals with serious mental illness.

Key Responsibilities:

Evaluate medical/pharmacy claims data and medical records for benefits eligibility
Guide community teams on level of application support for individuals
Create clinical summaries to support benefits program applications

Required Qualifications:

Evaluating claims and clinical documentation for benefits enrollment
Strong knowledge in medical care and treatment-related therapies
Experience in care plan creation and clinical documentation quality review
Ability to translate complex clinical requirements into actionable next steps for community teams
Familiarity with evidence required to support benefits applications

COMPLETE JOB DESCRIPTION

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