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RN Medical ReviewerVirtualVocations • Tampa, Florida, United States
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RN Medical Reviewer

RN Medical Reviewer

VirtualVocations • Tampa, Florida, United States
Hace 9 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo
Working remotely in a full-time capacity, the RN Medical Reviewer will perform medical reviews of claims, determine medical necessity, and document decisions based on clinical guidelines while supporting utilization practices. Key responsibilities Conduct medical claim reviews for complex services and preauthorization requests Make payment determinations based on clinical information and established criteria Educate internal and external staff on medical reviews and coding procedures Required qualifications Associate's degree in a job-related field or graduate of an accredited School of Nursing Active RN licensure in the state hired or an active compact multistate RN license At least 2 years of clinical experience Proficient in Microsoft Office and word processing software Ability to work independently and handle confidential information with discretion
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RN Medical Reviewer • Tampa, Florida, United States

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