Pennsylvania Licensed Clinical Access RN

Job Summary

A company is looking for a Registered Nurse - Clinical Access Specialist - Per Diem.

Key Responsibilities

• Perform medical record reviews for medical necessity and level of care determination
• Maintain knowledge of third-party payer health plans and regulatory requirements
• Review admission requests for compliance with pre-admission certification requirements

Required Qualifications, Training, and Education

• Graduate from a Specialty Training Program in Nursing
• Minimum of 3 years of nursing experience
• Licensed Registered Nurse in Pennsylvania
• Knowledge of nationally recognized review criteria and state and federal regulations
• Experience with utilization review and documentation integrity