To support a growing team, the full-time remote Clinical Reviewer (LPN, LVN, RN) will review medical records against established criteria to determine medical appropriateness while managing daily workloads and collaborating on quality improvement initiatives. Key responsibilities Assures accuracy and timeliness of medical record reviews within contract requirements Evaluates and adjusts daily workload to meet departmental demands and collaborates on quality monitoring activities Functions as a liaison for provider customer service issues and maintains current knowledge of review processes Required qualifications Active, unrestricted LPN, LVN, or RN license from the state of residence Associate's degree or practical/vocational nursing diploma or nursing certificate program Medical record abstracting skills, including knowledge of medical terminology and disease processes Strong clinical assessment and critical thinking skills Availability to work Monday-Friday, including occasional evening shifts as assigned
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