State Licensed RN Medical Reviewer
Job Summary
To support home health compliance efforts, the part-time State Licensed RN Medical Reviewer will conduct reviews of pre-claim packages, document outcomes with clinical rationale, and engage with providers to clarify documentation in a remote capacity.
Key Responsibilities
- Conduct comprehensive reviews of home health pre-claim review packages for compliance with Medicare criteria
- Document review outcomes in the case management system, ensuring a turnaround time within 7 business days
- Engage with providers to request or clarify documentation and escalate concerns or suspected fraud as needed
Required Qualifications
- Active, unrestricted RN license in the state of residence
- Minimum of 2 years of clinical experience
- At least 2 years of experience in home health, quality assurance, or utilization review
Complete Job Description
The complete job description is available to members. Premium membership includes:
Full access to 38,646 remote jobs from human-vetted companies, updated daily
Resume Builder - AI-powered tool to craft, enhance, and tailor your resume to a specific job
Twice-monthly live group coaching and the full Remote Career Center
20% member discount on Career Services
Backed by a 30-day money-back guarantee
Company Company Name
Headquarters Headquarters
Founded Founded
Website
The company description is available to members. Go Premium for full access to every job and company profile in our remote jobs database, backed by a 30-day money-back guarantee.
