Job Summary
A health insurance company is in need of a Remote Clinical Review Nurse I .
Individual must be able to fulfill the following responsibilities:
- Applying clinical knowledge to assess and ensure services/items billed are reasonable and necessary
- Adapting to a wide variety of medical review topics and multiple Medicare lines of business
- Articulating clearly with other clinicians to include medical doctors, nurses, and support personnel is required via teleconference education sessions
Skills and Requirements Include:
- Current unrestricted RN license
- Two (2) years’ clinical experience
- Knowledge of Medicare
- Ability to comprehend medical policy and criteria to clearly articulate health information
- Preferred experience in Hospice and Home Healt
- Demonstrated prioritization, problem solving, and organization skills
