Remote Medicare Pre Certification Utilization Review RN in Watertown

Job is Expired
Location: Massachusetts
Compensation: To Be Discussed
Staff Reviewed: Thu, Oct 25, 2018

Job Summary

A staffing agency is filling a position for a Remote Medicare Pre Certification Utilization Review RN in Watertown.

Individual must be able to fulfill the following responsibilities:

  • Review of pending list to ensure priorauthorization of authorization requests
  • Perform concurrent reviews related to acute admissions and SNF, and real time telephone reviews for medical services
  • Identify and determine benefit coverage for medical requests

Qualifications Include:

  • RN or BSN
  • Current unrestricted MA license required
  • Experience with managed care
  • Experience within a health insurance company
  • At least 2-5 years experience in a clinical or community based nursing setting
  • All other requirements necessary for this position

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