Nebraska Licensed Medical Review SpecialistVirtualVocations • Naples, Florida, United States
Nebraska Licensed Medical Review Specialist
VirtualVocations • Naples, Florida, United States
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A company is looking for a Medical Review Specialist : Post Service.
Key Responsibilities
Perform medical review to ensure compliance with contracts, regulations, and medical policies
Conduct accurate and timely medical reviews of claims, preauthorizations, and customer service inquiries
Collaborate with healthcare providers and internal teams to promote high-quality, cost-effective care
Required Qualifications, Training, and Education
Associate degree in nursing or Certified Practical Nurse with three years of clinical experience
Current, unrestricted Registered Nurse or Licensed Practical Nurse license from Nebraska or participating consortium state
Bachelor's degree in a healthcare field (preferred)
Certification in Managed Care (preferred)
Experience in medical review or utilization management (preferred)
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Medical Review Specialist • Naples, Florida, United States
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