Oklahoma Licensed Clinical Claim RN - job 1 of 2

Job Summary

A company is looking for a Clinical Claim Review RN in Oklahoma.

Key Responsibilities

• Perform clinical coverage review services interpreting state and federal mandates and clinical information
• Collaborate with a self-directed team to meet 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 manage a fast-paced production environment and multiple review types
• Proficiency in computer skills, including Microsoft Suite