South Carolina Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer - RN - Part-time (Remote U.S.)

Key Responsibilities

• Review and interpret patient records to assess medical necessity and appropriateness of care
• Determine approval or initiate referrals to physician consultants and process their decisions
• Maintain confidentiality of medical records and adhere to HIPAA policies

Required Qualifications

• Active, unrestricted Registered Nurse (RN) License in South Carolina or RN Compact State
• Minimum of an Associate or Bachelor's Degree in Nursing
• 2+ years of clinical experience in an acute or med-surgical environment
• Knowledge of medical records organization, medical terminology, and disease processes
• Strong clinical assessment and critical thinking skills