New Jersey Licensed Precertification Nurse

Job Summary

A company is looking for a Precertification Nurse (Remote - East coast).

Key Responsibilities

• Perform Pre-Certification to determine the medical necessity of requested services for New Jersey Auto No-Fault injuries
• Educate patients and the provider community regarding the Pre-Certification process and its governing laws
• Utilize medical coding knowledge (CPT and ICD-9/ICD-10) in the review process

Required Qualifications

• Graduate of an accredited school of nursing
• Active Nursing License in good standing - LPN/RN
• 3 years of Med-Surg experience required
• Knowledge of New Jersey Auto PIP / No-Fault preferred
• Familiarity with InterQual/Review Manager/CERME preferred