Medical Review Nurse - CA RN
SCAN Health Plan•Long Beach, CA
467d•$80,309 - $128,502•Remote
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About The Position
The Medical Review Nurse at SCAN is responsible for providing clinical review of medical claims and post-service appeals, ensuring compliance with Medicare guidelines and SCAN's standards. This role involves analyzing complex healthcare claims, conducting audits, and collaborating with medical directors to adjudicate claims and manage medical services effectively. The position supports the organization's mission to improve the health and independence of older adults by ensuring appropriate medical care and benefit administration.
