Job Summary
A provider of home health benefits management services has an open position for a Remote Durable Medical Equipment Clinical Reviewer.
Core Responsibilities of this position include:
- Performing an initial evaluation of the referral appropriateness
- Requesting additional clinical information when needed
- Determining if the service/device meets medical necessity for the patient
Position Requirements Include:
- Associate's Degree or Diploma in Nursing/Practical Nursing
- Registered Nurse/LPN/LVN with Licensure in the state(s) of practice
- hold an active, current and unrestricted license
- 1-2 years prior authorization experience for Medicare or Medicare Advantage Home Health
- 2 years in a clinical setting
- Strong knowledge of Medicare PDGM
