Nevada Licensed Clinical Claims RNVirtualVocations • Huntington Beach, California, United States
Nevada Licensed Clinical Claims RN
VirtualVocations • Huntington Beach, California, United States
4 days ago
Job type
- Full-time
Job description
A company is looking for a Clinical Claims Reviews RN - Remote.
Key Responsibilities
Conduct retrospective reviews for appropriateness of diagnostic procedures and coding levels
Evaluate medical necessity and determine appropriate levels of care for assigned claims
Prepare claims for medical director review and participate in special projects as assigned
Required Qualifications
Current, unrestricted RN license for the state of Nevada
2+ years of nursing experience in utilization review, case management, or clinical claims review
1+ years of experience working in a hospital or clinical setting
Proficiency with Microsoft Word, Excel, and Outlook
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Licensed Clinical • Huntington Beach, California, United States
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