Job Summary
A health insurance company needs applicants for an opening for a Telecommute PreService Review Registered Nurse.
Must be able to:
- Perform pre-service clinical coverage review of services
- Manage clinical Out of Network referral requests
- Obtain additional clinical information from treating physicians and other healthcare professionals
Applicants must meet the following qualifications:
- Current, unrestricted RN license in the state of residence
- New York state nursing license
- 3+ years of hands-on clinical experience in an inpatient, physician practice and / or acute setting
- Utilization management, prior authorization, or case management experience
- Proficient with Microsoft Word to create, edit, save, and send documents