Senior Medical Reviewer (RN) - Health Claims & Medical Necessity
Value Improvement
HCSC is seeking an experienced Registered Nurse to perform accurate and timely medical review of Texas and national accounts claims suspended for medical necessity, contract interpretation, and pricing. You will initiate and respond to correspondence from providers or members regarding medical determinations. Requirements include a current, unrestricted RN license in Texas (or reciprocity) with 3 years of clinical experience, plus strong verbal and written communication, analytical skills, and #J-18808-Ljbffr Value Improvement
Vacancy posted 3 days ago
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