Remote Utilization Review RN – Medical Necessity & Claims
A healthcare services company is seeking a full-time remote Registered Nurse (RN) to validate medical necessity and appropriateness of treatment plans. Candidates should have a minimum of 3 years clinical experience and possess strong communication and organizational skills. Proficiency in Microsoft applications and knowledge of health insurance legislation are vital. This role requires collaboration with providers and members regarding medical determinations, ensuring accurate and timely medical review of claims.
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