Louisiana Licensed Clinical Review Nurse

Job Summary

A company is looking for a Clinical Review Nurse - Concurrent Review.

Key Responsibilities

• Generate, process, and maintain provider and member correspondence for preservice and concurrent review
• Manage denial management systems, including claims, correspondence platform, and appeals tracking
• Prioritize tasks and check for updates on policy changes and internal communications

Required Qualifications

• Registered Nurse or Licensed Practical Nurse required
• Compact Nurse Licensure required
• 1-2 years of relevant experience
• Preferred: Registered Nurse licensure
• Experience in utilization management and denials is beneficial