Job Summary
An insurance company. needs applicants for an opening for a Remote RN Medical Reviewer II .
Core Responsibilities of this position include:
- Making reasonable charge payment determinations based on clinical/medical information and established criteria/protocol
- Performing medical claim reviews
- Determining medical necessity and appropriateness
Must meet the following requirements for consideration:
- Associate degree in nursing
- Active RN licensure in state hired
- Excellent communication skils
- Active compact multistate RN license as defined by the Nurse Licensure Compact (NLC).
