Job Summary
A provider of enterprise solutions and services is seeking a Telecommute Medical Review Specialist III.
Core Responsibilities of this position include:
- Performing comprehensive medical record and claims review
- Utilizing electronic health information imaging and inputting medical review decisions
- Utilizing internet and intranet sources for policy verification
Skills and Requirements Include:
- Must have and maintain a valid state driver’s license for the state of residence
- 3 years clinical experience as a Registered Nurse
- 4 years federal and local policy applications in relation to insurance procedures for medical necessity
- Current licensure as a Registered Nurse in one or more of the 50 states or D.C.
- Ability to keep sensitive and confidential material private
- Must have no adverse actions pending or taken against him/her by any State or Federal licensing board