Precertification Nurse (Remote - East coast)

MEDLOGIX, LLC • Hamilton Township, NJ

5d • $28 - $32 • Remote

About The Position

The role of Precertification Nurse is to perform Pre-Certification determining the medical necessity of requested services for New Jersey Auto No-Fault injuries.

Requirements

• New Jersey Auto PIP / No-Fault knowledge (Preferred)
• InterQual/Review Manager/CERME knowledge
• CPT and ICD-9/ICD-10 diagnosis coding knowledge
• Medical management related to auto claims knowledge (Preferred)
• Microsoft Office Suite programs knowledge
• Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition and grammar
• Strong interpersonal skills, communication and presentation skills
• Ability to use logic and reasoning to identify appropriate alternative course of care based on individual clinical outcomes
• Ability to work independently
• Detail oriented and able to multi-task
• Ability to type 45-50 words per minute
• 3 Years Med-Surg experience
• Utilization Review experience (Preferred)
• Ortho/Rehab experience (Preferred)
• Graduate of an accredited school of nursing
• Active Nursing License in good standing – LPN/RN

Responsibilities

• Perform Pre-Certification determining the medical necessity of requested services for New Jersey Auto No-Fault injuries.
• Provide instruction and direction to support staff.
• Educate patients and the provider community regarding the Pre-Certification process and its governing laws.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree