Utilization Review Nurse (LVN/LPN) - Medical Claims Auditor
Molina Healthcare
Molina Healthcare is seeking a nurse reviewer to evaluate documentation for medical necessity and appropriate level of care, applying MCG/InterQual, billing and coding rules, and Molina policies to ensure proper reimbursement to providers. The role involves reviewing claims, validating records, supporting LTSS and DRG reviews, presenting cases to leadership for hearings, and serving as a clinical resource for peers. #J-18808-Ljbffr Molina Healthcare
Vacancy posted 1 day ago
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