Anthem NGS Clinical Review Nurse I (Preferred location: Harrisburg, PA- Syracuse, NY Dennison, TX or Indianapolis, IN)- PS13257 in Evansville, Indiana

NGS Clinical Review Nurse I (Preferred location: Harrisburg, PA- Syracuse, NY Dennison, TX or Indianapolis, IN)- PS13257

Location: United States

Field: Medical

Requisition #: PS13257

Post Date: 4 days ago

The Clinical Review Nurse I position will be responsible for reviewing and making medical determinations as to whether a claim meets the benefits the member carries.

Primary duties may include, but are not limited to:

  • Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials.

Onsite location: Preferred location: Harrisburg, PA

Other sites considered: Syracuse, NY Dennison, TX or Indianapolis, IN

The position will be an in office position with the ability to work from home after 6 months

  • Requires an AS/BS in nursing; 1 year of clinical experience with an understanding of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license required.

  • Ability to comprehend medical policy and criteria to clearly articulate health information required.