Remote Precertification Nurse (LPN/RN) – Auto No-Fault

MEDLOGIX; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Medlogix, LLC is seeking a Precertification Nurse (LPN/RN) to determine medical necessity for auto No-Fault claims. This full-time role is remote with training in Hamilton, NJ, and requires NJ nursing licensure and 3 years med-surg experience.

The candidate will utilize InterQual/Review Manager/CERME, possess strong communication skills, and educate patients and providers about the precertification process and governing laws. Proficiency in CPT/ICD coding and MS Office is preferred.

Qualifications

• Graduate of an accredited nursing school.
• Active New Jersey State Nursing License (LPN/RN) required.
• Minimum 3 years Med-Surg experience; Utilization Review preferred.

Responsibilities

• Perform precertification determining medical necessity for services in auto No-Fault cases.
• Educate patients and provider communities about precertification processes and applicable laws.
• Use InterQual/Review Manager/CERME for reviews and documentation.
• Communicate clearly and coordinate with care teams and departments.

Skills

Interpersonal skills

Communication

Independent work

Educating patients

Education

Nursing degree

Tools

Microsoft Office

Job description

Medlogix, LLC is seeking a Precertification Nurse (LPN/RN) to determine medical necessity for auto No-Fault claims. This full-time role is remote with training in Hamilton, NJ, and requires NJ nursing licensure and 3 years med-surg experience.

The candidate will utilize InterQual/Review Manager/CERME, possess strong communication skills, and educate patients and providers about the precertification process and governing laws. Proficiency in CPT/ICD coding and MS Office is preferred.