What are the responsibilities and job description for the UM Nurse Reviewer position at HIGH DESERT MEDICAL CORP, A MEDICAL GRP?
Seeking a candidate to fill position for UM Nurse Reviewer. Candidate must have a managed care background, knowledge of Medicare and Medi-Cal and knowledge of health plan and CMS guidelines. Candidate must also have the ability to review and make determination of requests for clinical services. Excellent computer skills and the ability to type at least 45 WPM. Claims review experience is a plus and bilingual is a plus.
Summary of Job Duties include: review requests for clinical care appropriateness, defer potential denials to MD and other duties as assigned.
Requirements:
High School Diploma, Licensed Vocational Nurse (LVN)
Compensation: $29.00-$39.93
Summary of Job Duties include: review requests for clinical care appropriateness, defer potential denials to MD and other duties as assigned.
Requirements:
High School Diploma, Licensed Vocational Nurse (LVN)
Compensation: $29.00-$39.93
Salary : $29 - $40
