Job Summary
A healthcare company has a current position open for a Telecommute Clinical Reviewer.
Candidates will be responsible for the following:
- Performing an initial evaluation of the referral appropriateness for services
- Reviewing for information needed to make a medical necessity determination
- Requesting additional clinical information when needed
Applicants must meet the following qualifications:
- Associate's Degree or Diploma in Nursing
- Registered Nurse/LPN/LVN with Licensure in the state(s) of practice
- Hold an active, current and unrestricted license
- A minimum of 1-2 years prior authorization experience for Medicare or Medicare Advantage Home Health
- A minimum of 2 years in a clinical setting
