Remote Sleep Clinical Reviewer

Job is Expired
Location: Nationwide
Compensation: To Be Discussed
Staff Reviewed: Wed, May 18, 2022
Job Summary

A company that provides home health benefits management services for healthcare providers has a current position open for a Remote Sleep Clinical Reviewer.

Individual must be able to fulfill the following responsibilities:

  • Perform an initial evaluation of the referral appropriateness for the company's services
  • Request additional clinical information when needed to render a decision and determine next steps
  • Use clinical expertise, review clinical information and clinical criteria to determine if the service/device meet medical necessity for the patient

Applicants must meet the following qualifications:

  • Associate's Degree or Diploma in Nursing/Practical Nursing
  • Registered Nurse/LPN/LVN with Licensure in the state(s) of practice (based on allowable state practice act)
  • Active, current and unrestricted license
  • 1-2+ years prior authorization experience for Medicare or Medicare Advantage Home Health
  • 2+ years in a clinical setting
  • Proficient analytical, negotiation, communication, problem solving and decision making skills
COMPLETE JOB DESCRIPTION

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