Ohio Licensed Clinical Review Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025
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Job Description:
A company is looking for a Clinical Appeal & Claim Review Nurse
II.
Key Responsibilities
Independently evaluates medical claims and appeal cases to assess
service appropriateness
Summarizes medical information for physician review and generates
written status updates
Acts as a resource for providers and collaborates with internal
departments to ensure appropriate member care
Required Qualifications
Graduate of a registered nursing program approved by the Ohio State
Nursing Board; Bachelor's degree preferred
3 years of experience as a Registered Nurse in acute care, critical
care, or relevant clinical settings
Registered Nurse with a current State of Ohio unrestricted
license
Familiarity with clinical claim management, medical terminology,
and healthcare regulations
PC and keyboarding proficiency; Intermediate Microsoft Office
skills
Keywords: VirtualVocations, Diamond Bar , Ohio Licensed Clinical Review Nurse, Healthcare , Vista, California
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