Temp Clinical Letter Writer – Medical Necessity & Authorization

Act for Health, Inc; United States; Remote; USD 35,000 - 50,000; Full time

Job summary

Professional Case Management (PCM) is seeking a Nurse Case Reviewer to collect and review client medical records and clinical documentation to support Department of Labor authorizations for a defined caseload.

The role requires an RN with current state licensure, 2+ years of healthcare experience, excellent research, writing, editing and oral communication skills, and strong computer skills. You will draft medical necessity letters, review authorizations, and collaborate with the care team.

Qualifications

• Registered Nurse with current State licensure preferred
• Minimum of two years of healthcare experience preferred
• Excellent research, writing, editing and oral communication skills
• Strong computer skills
• Attention to details and ability to translate into clinical documentation
• Ability to work independently as well as collaboratively
• Licensed driver with clean driving record and insured in accordance with state and/or Agency requirements.

Responsibilities

• Researches diagnoses and treatment strategies related to client’s covered conditions and relates this information when writing correspondence regarding client authorizations, denials and changes in level of care.
• Write draft letter of medical necessity for the purpose of authorization and recertification of client care.
• Review authorization and recertification paperwork, as requested, and communicate with appropriate team members when clarification is needed.

Skills

RN licensure

Healthcare experience

Research and writing

Oral communication

Computer skills

Attention to detail

Independent worker

Driver’s license

Education

RN license

Tools

MS Office

Job description

Professional Case Management (PCM) is seeking a Nurse Case Reviewer to collect and review client medical records and clinical documentation to support Department of Labor authorizations for a defined caseload.

The role requires an RN with current state licensure, 2+ years of healthcare experience, excellent research, writing, editing and oral communication skills, and strong computer skills. You will draft medical necessity letters, review authorizations, and collaborate with the care team.