Alabama Licensed Medical Reviewer
VirtualVocationsSan Jose, California, United Statesjob_description.job_card.1_day_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Medical Reviewer II to perform medical reviews and support medical claims.
Key Responsibilities
Conducts medical claim reviews and determines medical necessity based on established criteria and guidelines
Educates staff on medical reviews, terminology, and coverage determinations
Participates in quality control activities and provides guidance to team members
Required Qualifications
Associate Degree in Nursing or Graduate of an Accredited School of Nursing
Active, unrestricted RN license from the United States or a compact multistate RN license
Two years of clinical experience as an RN
Proficiency in Microsoft Office
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Medical Reviewer • San Jose, California, United States
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