Remote Clinical Review Nurse - Concurrent Review

A-Line Staffing Solutions; Mississippi; A distancia; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

A-Line Staffing Solutions is seeking a Clinical Review Nurse for a concurrent review role in a remote-capable setting. The RN will assess member eligibility through chart review and coordinate with providers to gather necessary information.

You will document findings and ensure compliance with regulatory and insurance guidelines while collaborating with healthcare teams. The position emphasizes timely communication, quality review processes, and participation in team meetings to enhance workflow

Formación

• RN license is required.
• BSN or related nursing degree preferred.

Responsabilidades

• Review clinical records to assess member eligibility and appropriateness of services.
• Coordinate with provider and member to obtain additional information as needed.
• Document findings and communicate effectively with healthcare teams.
• Maintain compliance with regulatory and insurance guidelines.
• Participate in team meetings to improve review processes.

Descripción del empleo

A-Line Staffing Solutions is seeking a Clinical Review Nurse for a concurrent review role in a remote-capable setting. The RN will assess member eligibility through chart review and coordinate with providers to gather necessary information.

You will document findings and ensure compliance with regulatory and insurance guidelines while collaborating with healthcare teams. The position emphasizes timely communication, quality review processes, and participation in team meetings to enhance workflow