Medical Claim Review Nurse

Job Title This role is fully remote and candidates should be in the following states: AZ, FL, ID, IA, GA, KY, MI, NE, NM, OH, TX, UT, WI, WA. The expected schedule is 9-5 PST Pacific time Zone, with alternate weekend rotations on Saturday and on-call Sunday. Day to day responsibilities include utilizing clinical knowledge and experience to review documentation for medical necessity and appropriate level of care, applying MCG/InterQual, state/federal guidelines, billing and coding regulations, a…