RN Medical Reviewer II

Job is Expired
Location: Remote
Compensation: To Be Discussed
Reviewed: Tue, Aug 20, 2024

Job Summary

A company is looking for a RN Medical Reviewer II (Medicare Part A).

Key Responsibilities:
  • Perform medical claim reviews for complex services, preauthorization requests, and appeals
  • Determine payment based on clinical information and established criteria
  • Educate staff on medical reviews, coding procedures, and coverage determinations

Required Qualifications:
  • Active, unrestricted RN licensure in the US or compact multistate RN license
  • Associates degree in a related field or graduate of an Accredited School of Nursing
  • Two years of clinical nursing experience
  • Working knowledge of word processing software
  • Microsoft Office proficiency

COMPLETE JOB DESCRIPTION

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