Medical Claims Review Nurse

Job is Expired

Location: Remote

Compensation: To Be Discussed

Staff Reviewed: Mon, Jun 03, 2024

Job Category: Healthcare

Employer Type: Staffing Agency

Career Level: Experienced

Job Summary

A company is looking for a Medical Claims Review Nurse.

Key Responsibilities:

Reviewing medical patient records against standard medical criteria
Performing clinical/medical reviews of retrospective medical claim reviews, medical claims, and previously denied cases
Identifying and reporting quality of care issues and serving as a clinical resource for various stakeholders

Required Qualifications, Training, and Education:

Three years of clinical appeals experience
One year of utilization review experience
DRG experience on resume preferred for interview consideration
BSN preferred for education
Active, unrestricted State Registered Nursing (RN) license in good standing required

COMPLETE JOB DESCRIPTION

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Job is Expired

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