The Role
Review client medical records and clinical documentation, research diagnoses and treatments, and draft letters of medical necessity for authorizations, recertifications, denials, and level-of-care changes. Communicate with team members for clarifications and manage assigned client caseloads.
Summary Generated by Built In
Make a Difference on Your Own Schedule and Terms!
This position is responsible for gathering and reviewing client medical records and clinical documentation to assist in documenting clinical needs to present to the Department of Labor for authorization of care for an assigned number of clients.
QUALIFICATIONS:
Registered Nurse with current State licensure preferred
Minimum of two years of healthcare experience preferred
Excellent research, writing, editing and oral communication skills
Strong computer skills
Ability to pay attention to various details and can quickly understand and translate those details into clinical documentation
Ability to work independently as well as collaboratively as part of a team
- Licensed driver with clean driving record and insured in accordance with state and/or Agency requirements.
ESSENTIAL FUNCTIONS/AREAS OF ACCOUNTABILITY
- Researches diagnoses and treatment strategies related to client’s covered conditions and relates this information when writing correspondence regarding client authorizations, denials and changes in level of care.
- Write draft letter of medical necessity for the purpose of authorization and recertification of client care.
- Review authorization and recertification paperwork, as requested, and communicate with appropriate team members when clarification is needed.
Standard Rate: $38.00 Hourly plus shift differentials, where applicable.
Please contact Mark Rainey II at or at [email protected] today to learn more about our opportunities where you can make a difference in your own career!
Professional Case Management is an Equal Opportunity Employer.
Skills Required
- Registered Nurse with current State licensure
- Minimum of two years of healthcare experience
- Excellent research, writing, editing and oral communication skills
- Strong computer skills
- Ability to pay attention to details and translate them into clinical documentation
- Ability to work independently and collaboratively as part of a team
- Licensed driver with clean driving record and insured per state/agency requirements
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The Company
