Florida Licensed Medical Review Nurse
VirtualVocationsAppleton, Wisconsin, United Statesjob_description.job_card.30_days_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 Review Nurse (RN).
Key Responsibilities
Review and authorize referral and authorization requests based on established criteria and compliance standards
Assess requests not approved by support staff to determine benefit coverage and medical necessity
Collaborate with Medical Directors on potential denials and case reviews
Required Qualifications
RN license issued by the state (compact license acceptable)
High school diploma or GED
Understanding of Medicare Prior Authorization and CMS rules and regulations
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Medical Review Nurse • Appleton, Wisconsin, United States
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