Registered Nurse

Responsibilities:

Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.

Consults with medical and treatment staff regarding client diagNosis, medical justification, length of treatment, and case documentation.

Communicate with physicians to ascertain their plans for a timely discharge.

Handle inbound and outbound calls from patients and healthcare providers

Analyze and determine eligibility of medical claims

Coordinate with providers and specialists in assessing validity of claims

Full-Time