Oklahoma Licensed Clinical Claim RN

Job Summary

A company is looking for a Clinical Claim Review RN.

Key Responsibilities

• Perform clinical coverage review services based on state and federal mandates and clinical information
• Collaborate with a self-directed team to achieve individual and team performance metrics
• Communicate benefit determinations regarding coverage guidelines and reimbursement decisions

Required Qualifications

• Current unrestricted RN license in the state of residency
• 3+ years of RN experience, including clinical experience in an inpatient/acute setting
• Proven exemplary clinical documentation skills
• Ability to work independently in a fast-paced production environment
• Demonstrated proficiency in computer skills, including Microsoft Suite