South Carolina RN Medical Reviewer
Company: VirtualVocations
Location: Far Rockaway
Posted on: April 5, 2025
|
|
|
Job Description:
A company is looking for an RN Medical Reviewer III (Reporting
and Research).
Key Responsibilities
Perform medical claim reviews and determine medical necessity and
appropriateness for coverage and reimbursement
Educate internal and external staff on medical reviews,
terminology, and coding procedures
Participate in quality control activities and assist with special
projects as assigned by management
Required Qualifications, Training, and Education
Active, unrestricted RN licensure in the state of hire or a compact
multistate RN license
Associate degree in Nursing or a bachelor's degree in a
health-related field
Two years of clinical experience plus two years in
utilization/medical review or quality assurance
Working knowledge of managed care and healthcare delivery
systems
Proficiency in Microsoft Office, particularly Excel for reporting
and research tasks
Keywords: VirtualVocations, New York , South Carolina RN Medical Reviewer, Healthcare , Far Rockaway, New York
|
Click
here to apply!
|
