Florida Licensed Medical Review Nurse
Company: VirtualVocations
Location: Santa Clara
Posted on: February 19, 2025
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Job Description:
A company is looking for a Pre-Service Medical Review Nurse
RN.
Key Responsibilities:
Review and resolve complex processing issues and utilization
management cases for Pre-Service healthcare services
Process Pre-Service Medical Review requests and conduct reviews of
subscriber's medical information for benefit administration
Provide customer service to plan members and conduct training for
new staff members and providers as needed
Required Qualifications:
3+ years of related work experience in utilization management, case
management, or clinical settings
1 year of utilization management experience, including knowledge of
CMS Regulatory Guidelines
Knowledge of ICD-10 Codes
RN - Registered Nurse - State Licensure and/or Compact State
Licensure
Basic PC knowledge is preferred
Keywords: VirtualVocations, Santa Clara , Florida Licensed Medical Review Nurse, Healthcare , Santa Clara, California
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