Mississippi Licensed Clinical Review Nurse
Job Summary
Working remotely in a full-time capacity, the Mississippi Licensed Clinical Review Nurse will review clinical records to assess member eligibility and appropriateness of services while coordinating with providers and members to obtain necessary information.
Key responsibilities
- Review clinical records to determine member eligibility and service appropriateness
- Document findings and communicate effectively with healthcare teams
- Maintain compliance with regulatory and insurance guidelines
Required qualifications
- Current RN license in Mississippi
- Preferred BSN or related nursing degree
- Experience in clinical review or related nursing field
- Knowledge of regulatory and insurance compliance standards
- Ability to work standard shift hours as designated by the team
Complete Job Description
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