Remote DME Clinical Reviewer

Job Summary

A home health benefits management service provider is filling a position for a Remote DME Clinical Reviewer.

Core Responsibilities Include:

• Performing an initial evaluation of the referral appropriateness for CareCentrix services
• Requesting additional clinical information when needed to render a decision and determine next steps
• Reviewing for information needed to make a medical necessity determination

Qualifications for this position include:

• Have an Associate's Degree or Diploma in Nursing/Practical Nursing (required)
• Hold an active, current and unrestricted license
• Are a Registered Nurse/LPN/LVN with Licensure in the state(s) of practice
• Have a minimum of 2 years in a clinical setting (required)
• Have a minimum of 1-2 years prior authorization experience for Medicare or Medicare Advantage Home Health required