RN Review Analyst
Schedule: Tuesday - Saturday 9a - 6p (No Holidays!)
Responsible for the approval or rejection of claims, admissions approvals, telephone triage, and/or benefit interpretation. May be required to enter or reference data via PC and/or CRT terminal. Other related skills may be required to perform this job. Utilize Interqual criteria and CMS Guidelines for approval or rejection of claims.
- Registered Nurse with current and unrestricted Michigan RN license.
- Associate Degree or nursing diploma required.
- Two (2) years patient care experience.
- Triage, case management and/or rehabilitation experience preferred.
- expertise in the use of medical terminology.