South Carolina Licensed RN Coordinator

Job Summary

A company is looking for an RN Medical Affairs Coordinator.

Key Responsibilities

• Develops and maintains Local Coverage Determinations (LCDs) under medical direction
• Educates providers and internal staff on LCDs and ensures compliance with coding and reimbursement guidelines
• Provides clinical input for internal requests and reviews for inter-rater reliability

Required Qualifications

• Bachelor's degree in a related field or graduate of an accredited nursing program
• 5 years of clinical experience in medical insurance, managed care, case management, or claims management
• Active, unrestricted RN license from the United States or compact multistate RN license
• Knowledge of managed care or medical claims payment policy issues
• Proficiency in Microsoft Office software