South Carolina Licensed Medical Reviewer
Company: VirtualVocations
Location: Canton
Posted on: March 28, 2025
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Job Description:
A company is looking for a Medical Reviewer II to perform
medical reviews and support medical claims and utilization
practices.
Key Responsibilities
Perform medical claim reviews for various services and determine
medical necessity based on clinical information and established
guidelines
Educate internal and external staff on medical reviews,
terminology, and coverage determinations
Participate in quality control activities and provide guidance to
team members while assisting with special projects as needed
Required Qualifications
Graduate of an accredited school of nursing or an associate's
degree in a job-related field
Two years of clinical experience
Active RN licensure in the state hired or an active compact
multistate RN license
Working knowledge of word processing software and Microsoft
Office
Ability to work independently and prioritize effectively
Keywords: VirtualVocations, Canton , South Carolina Licensed Medical Reviewer, Healthcare , Canton, Ohio
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