Senior RN - Medical Review & Utilization Specialist

Integrated Resources Inc.; Chattanooga (TN); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading staffing firm seeks a clinical reviewer with strong analytical skills and a minimum of 5 years of clinical experience. The ideal candidate will possess an active RN license in Tennessee and be proficient in evaluating medical records and claims. This role requires effective communication, organizational skills, and the ability to conduct detailed reviews to support clinical determinations. Join a dedicated team committed to providing quality service and upholding high professional standards.

Qualifications

• Minimum of 5 years clinical experience required.
• Must be PC literate and experience with Windows and Microsoft Office.
• Ability to work independently and manage multiple tasks.

Responsibilities

• Perform pre-existing reviews and make clinical determinations.
• Provide documentation for rationale of determinations.
• Interact with various departments to ensure guidelines are followed.

Skills

Verbal communication

Written communication

Problem solving

Organizational skills

Leadership

Interpersonal skills

Education

Active registered nurse license in Tennessee

BSN preferred

Tools

Microsoft Office

FACETS

FileNet

Job description

A leading staffing firm seeks a clinical reviewer with strong analytical skills and a minimum of 5 years of clinical experience. The ideal candidate will possess an active RN license in Tennessee and be proficient in evaluating medical records and claims. This role requires effective communication, organizational skills, and the ability to conduct detailed reviews to support clinical determinations. Join a dedicated team committed to providing quality service and upholding high professional standards.