Nurse RN 5

Day to Day Responsibilities

(Being thorough in this section will allow the suppliers to pre-identify candidates more accurately.)

• In this role the nurse will review clinical claims and determine if the retrospective claims should be paid according to our benefits and/or policy.

Required Skills (top 3 non-negotiables):

• Strong Clinical Judgement, RN/LVN minimum 2 years of experience
• Strong computer skills
• Works well independently with minimal supervision

Preferred Skills (nice to have):

• Detail oriented
• Prior work history of Post Service, Prior Auth, Concurrent review. Preferential interview consideration for Post Service experience.
• Lives in California

Disqualifiers/ Dislikes on Resumes:

• Incomplete resumes with gaps in time or hasn''t worked in a role recently

Education Requirements:

• RN/LVN licensed in California

Required Testing:

Software Skills Required:

• [i.e.: MS Office Suite apps, JIRA, EMR Systems, etc.]

Required Certifications: