Alabama Licensed Medical Reviewer

A company is looking for a Medical Reviewer II to perform medical reviews and support medical claims.

Key Responsibilities

Conducts medical claim reviews and determines medical necessity based on established criteria and guidelines

Educates staff on medical reviews, terminology, and coverage determinations

Participates in quality control activities and provides guidance to team members

Required Qualifications

Associate Degree in Nursing or Graduate of an Accredited School of Nursing

Active, unrestricted RN license from the United States or a compact multistate RN license

Two years of clinical experience as an RN

Proficiency in Microsoft Office