Job Summary

A healthcare company needs applicants for an opening for a Telecommute Clinical Review Nurse I.

Candidates will be responsible for the following:

• Making clinical determinations for payment supporting claims submitted to Medicare
• Assessing and ensuring services/items billed are reasonable and necessary
• Adapting to a wide variety of medical review topics and multiple Medicare lines of business

Qualifications for this position include:

• Two (2) years’ clinical experience
• Excellent communication skills
• Demonstrated prioritization, problem solving, and organization skills.
• Strong computer skills, including Microsoft Office proficiency
• Demonstrated proficiency as a Clinical Reviewer or equitable position