Remote Initial Clinical Claim Utilization Review Nurse

Job is Expired
Location: Nationwide
Compensation: To Be Discussed
Staff Reviewed: Thu, May 24, 2018

Job Summary

A healthcare company is in need of a Remote Initial Clinical Claim Utilization Review Nurse.

Must be able to:

  • Provide clinical review and decision-making following specific clinical coverage position criteria
  • Conduct clinical determinations and/or recommendations on both Pre-service and Post-service Inpatient and Outpatient services
  • Conduct clinical appeal reviews for both level 1 and level 2 healthcare professionals

Position Requirements Include:

  • Valid RN licensure without in the state of residency without any restrictions or stipulations
  • 1 year of nursing experience
  • Strong computer skills
  • Strong typing skills
  • Works well independently
  • Strong problem solving and critical thinking skills

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