State Licensed Clinical Claims Nurse 3132634 I.Html

Utilizing clinical judgment, the full-time State Licensed Clinical Claims Nurse will review and interpret clinical documentation, apply clinical decision-making for post-service claims, and coordinate clinical resolutions while working remotely.

##### Key responsibilities

Review and interpret clinical documentation from medical records or systems

Apply clinical criteria and policies for post-service claims and coordinate resolutions

Act as a resource for customer service and claims processing teams, while training new and existing staff

##### Required qualifications

Nursing degree (RN)

A minimum of 2-3 years of professional experience as a licensed Registered Nurse (RN) or equivalent clinical experience

Strong analytical skills to assess medical claims