Wisconsin Licensed Review Nurse

Job Summary

A company is looking for a Professional Review Nurse.

Key Responsibilities

• Analyze medical services to determine the appropriateness of charges on medical bills
• Collect and analyze data to assess billing accuracy and appropriateness of medical care
• Document findings and conclusions in designated computer programs

Required Qualifications, Training, and Education

• Current licensure as a Registered Nurse with a minimum of 4 years of clinical experience
• Associate Degree in Nursing with knowledge of C.P.T. and I.C.D.9 codes preferred
• Medical bill auditing experience preferred
• Experience in clinical areas such as O.R., I.C.U., C.C.U., E.R., and orthopedics preferred
• Utilization review experience (prospective, concurrent, and retrospective) preferred