Minnesota Licensed Clinical Claim RN

Job Summary

A company is looking for a Clinical Claim Review RN.

Key Responsibilities

• Perform clinical coverage review services interpreting state and federal mandates and relevant clinical information
• Function as a member of 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 handle a fast-paced production environment and multiple review types
• Demonstrated proficiency in computer skills, including Microsoft Suite