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Medical Reviewer, Medicare
Location
United States
Posted
54 days ago
Salary
Not specified
Job Description
Job Requirements
- Active, unrestricted RN license in the U.S. and in the state of hire OR
- Active compact multistate RN license (as defined by the Nurse Licensure Compact)
- Associate Degree in Nursing OR
- Graduate of an accredited School of Nursing
- Two years of clinical experience plus at least two years in one of the following:
- Inpatient/Outpatient settings (i.e. medical-surgical, rehabilitation, SNF, etc..)
- Utilization/Medical Review
- Quality Assurance
- Strong clinical background in managed care and/or inpatient/outpatient settings
- Ability to interpret and apply medical review criteria and clinical guidelines
- Proficiency in Microsoft Office and word processing software
- Strong analytical, organizational, and decision-making skills
- Ability to work independently while managing priorities effectively
- Excellent customer service, communication, and critical thinking skills
- Ability to handle confidential information with discretion
Benefits
- High-speed internet (non-satellite) and a private, lockable home office
- All necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.
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