RN LPN LVN Clinical Reviewer
Company: VirtualVocations
Location: Durham
Posted on: September 21, 2023
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Job Description:
A company is looking for a Clinical Reviewer.
Key Responsibilities:
Perform initial evaluation of referral appropriateness for services
and review for necessary information
Use clinical expertise to determine if services meet medical
necessity for patients
Ensure timely case review and elevation to meet contractual and
regulatory requirements
Required Qualifications:
Associate's Degree or Diploma in Nursing/Practical Nursing
Registered Nurse/LPN/LVN with licensure in state(s) of practice
Minimum 1-2 years prior authorization experience for Medicare or
Medicare Advantage Home Health
Minimum 2 years in a clinical setting
Strong knowledge of Medicare PDGM and 1-2 years process experience
strongly desired
Keywords: VirtualVocations, Durham , RN LPN LVN Clinical Reviewer, Healthcare , Durham, North Carolina
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here to apply!
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