Nursing Role

3 weeks ago


Beverly Hills, California, United States Emonics, LLC Full time
Overview:

We are seeking a skilled RN to join our team as a Utilization Review Specialist. This role is responsible for reviewing medical records and determining the necessity of treatments and services.

Responsibilities:

The ideal candidate will have 3 years of clinical experience in hospital or urgent care settings, with knowledge of ICD10, CPT, and HCPC coding systems. Familiarity with HMO, PPO, and POS plans is also required.

Requirements:
  • RN license in California
  • 3 years of clinical experience in hospital or urgent care
  • Utilization review experience
  • Knowledge of ICD10, CPT, and HCPC
  • Familiarity with HMO, PPO, and POS plans
Preferred Qualifications:
  • Managed care experience
  • Knowledge of medical management process
  • Knowledge of NCQA regulations
Salary:

$95,000 - $125,000 per year, depending on experience.

],

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