Reviewing Medicare Part A appeals, the full-time Clinical Adjudicator, RN will render medical necessity determinations, resolve technical issues, and conduct case reviews in a remote setting. Key responsibilities Review favorable and partially favorable determinations in accordance with applicable regulations Render medical necessity determinations for assigned cases Conduct reviews of cases or sites to summarize facts and assess identified issues Required qualifications Bachelor's degree required Active RN license required Minimum 2 years of clinical experience required with RN license Commitment to a training schedule of 8:00am - 4:30pm EST Monday - Friday Experience with medical records preferred
Clinical Adjudicator, RN in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.