Nurse Reviewer, RN
Ascellon Corporation - Landover, MD

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The Nurse Reviewer will be responsible for pre-admissions reviews, admitting records, and physicians’ orders for patients. Upon spotting cases that may result in a denial of services after a utilization review, the Nurse Reviewer will gather information about the case. The Nurse Reviewer will consult with doctors and other healthcare providers about the circumstances that surrounded a situation, gathering documentation in preparation for an appeal.

Qualifications:
  • Registered Nurse with an active state licensure.
  • Minimum two (2) years of experience as a RN with one (1) or more of the following:
1. Respiratory disease

2. Physical disability

3. Developmental disabilities

4. Chronic disease process

5. Mental illnesses

6. Pediatric disease processes
  • Knowledge and experience with Medicaid programs and regulations preferred
  • Superior communication skills required
  • Strong attention to detail required
  • Strong computer skills required

Ascellon Corporation - 22 months ago - save job - block
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