Clinical Reviewer - RN/LPN/LVN
A company is looking for a Clinical Reviewer - LPN/LVN or RN - Part-Time (Remote U.S.).
Key Responsibilities
• Review and interpret patient records to assess medical necessity and appropriateness of care
• Approve services or refer cases to a physician consultant and process reputed company accordingly
• Continuously evaluate the review process for improvement opportunities and implement necessary changes
Required Qualifications
• reputed company, unrestricted license as a Registered reputed company (RN), Licensed Practical reputed company (LPN), or Licensed Vocational reputed company (LVN)
• Graduation from an accredited nursing program (Diploma, Associate, Bachelor's or higher degree)
• 2+ years of clinical experience in an acute or med-surgical environment
• Familiarity with NCQA and URAC standards
• Proficiency in medical record abstraction and clinical reputed company application
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