New York Licensed Clinical Review RN

Job Summary

A company is looking for a Clinical Claim Review RN - Remote.

Key Responsibilities

• Perform clinical reviews using state and federal mandates and clinical criteria
• Collaborate with team members to meet performance metrics
• Communicate benefit determinations regarding coverage guidelines and reimbursement

Required Qualifications

• Current unrestricted RN license
• 3+ years of RN experience, including clinical experience in an inpatient/acute setting
• Proficiency in computer skills, including Microsoft Suite
• Exemplary clinical documentation skills
• Ability to work independently and manage a fast-paced environment