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Kentucky Licensed Clinical Quality Nurse
VirtualVocationsColumbus, Ohio, United States10 days ago
Job type
- Full-time
Job description
A company is looking for a Clinical Quality Nurse Reviewer, Sr. Specialist.
Key Responsibilities
Perform QA checks on complex clinical claim reviews
Review and analyze claim data and medical records using approved guidelines
Document determinations clearly and concisely
Required Qualifications
Active, unrestricted RN license in the U.S. and in the candidate's state of primary residence, with a current multistate compact (NLC) license required
Associate degree required; bachelor's degree preferred
5+ years clinical experience in an acute setting
3+ years medical record review / auditing experience preferred
Expert level experience applying MCG and / or InterQual criteria
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Clinical Quality Nurse • Columbus, Ohio, United States
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