Job Summary
A managed healthcare and benefits company is filling a position for a Remote Medical Claim Review Registered Nurse.
Individual must be able to fulfill the following responsibilities:
- Perform clinical/medical reviews of retrospective medical claim reviews
- Identify and report quality of care issues
- Assist with Complex Claim review
Position Requirements Include:
- RN, BSN, or LCSW
- Bachelor's Degree in Nursing or Health Related Field
- Minimum three years clinical nursing experience
- Claims Review experience
- Minimum one year Utilization Review and/or Medical
- Active, unrestricted State Registered Nursing (RN) license in good standing