Job Description: JOB SUMMARY. The Medical Review Nurse LPN reviews, authorizes, coordinates, and responds to requests for services for Client members. This position also communicates telephonically with providers and their offices, and occasionally with members. Makes decisions based on established policies and procedures, Client medical coverage guidelines, benefits, InterQual criteria, nursing knowledge. Refers cases to Client medical directors...
Williams Consulting LLC is seeking candidates for Medical Review Nurse positions to join our growing team. This is a 100% remote position in support of the Centers for Medicare and Medicaid Services. Program Integrity Efforts. Williams. Consulting LLC is an 8a, HUBZone and Woman-owned Small Business with Federal, State, Local and Commercial clients. We take great pride in our ability to provide exceptional customer service and we value our emplo...
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. Grade 7 POSITION PURPOSE Responsible for coordinating, processing and managing all in-patient and out-patient claims from a medical standpoint to ...
