West Virginia Licensed Review Nurse
Company: VirtualVocations
Location: Tyler
Posted on: March 22, 2025
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Job Description:
A company is looking for a Medical Necessity Review Nurse.
Key Responsibilities
Evaluate requested services to determine medical necessity using
payer criteria and clinical guidelines
Review medical records to support the clinical picture and
complexity of patient care
Research and prepare appeal files in response to preservice
clinical denials
Required Qualifications, Training, and Education
Associate degree in Nursing or bachelor's degree in nursing with
NCLEX for Registered Nurses, or Licensed Practical Nurse with
NCLEX-PN
Three years of experience in direct patient care or hospital
revenue cycle and authorization management
Registered Nurse or Licensed Practical Nurse preferred
Prior medical necessity review experience preferred
Keywords: VirtualVocations, Tyler , West Virginia Licensed Review Nurse, Healthcare , Tyler, Texas
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