Job Description:

• Reviews claims reimbursements
• Handles blended voice and non voice support.
• Clinical Review Nurses – Nurse conducts clinical review of cases not meeting criteria by performing clinical intake and adjudicates (closes), requests additional clinical information or escalates to Medical Directors.

Qualifications:

• Must have an active USRN and PRC License
• Must have 2 years hospital/clinical setting experience
• BPO experience is a plus
• Excellent Communication skills