Anthem NGS Clinical Review Nurse I, Remote (PS6504) in Reno, Nevada

NGS Clinical Review Nurse I, Remote (PS6504)

New

Location: United States

Field: Medical

Requisition #: PS6504

Post Date: 5 days ago

Your Talent. Our Vision. At National Government Services (NGS) , an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country, it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care .

The Clinical Review Nurse I is responsible for reviewing and making medical determinations as to whether a claim meets the benefits the member carries.

This Is A Remote Based Position

Primary duties may include, but are not limited to:

  • Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials.

  • Requires an AS/BS in nursing; 1 year of clinical experience with an understanding of clinical experience; or any combination of education and experience, which would provide an equivalent background.

  • Current unrestricted RN license required.

  • Ability to comprehend medical policy and criteria to clearly articulate health information required.

  • Requires an AS/BS in nursing; 1 year of clinical experience with an understanding of clinical experience; or any combination of education and experience, which would provide an equivalent background.

  • Current unrestricted RN license required.

  • Ability to comprehend medical policy and criteria to clearly articulate health information required.

This is an exceptional opportunity to do innovative work that means more to you and those we serve.