[Hiring] Precertification Nurse @MEDLOGIX, LLC

Role Description

The role of Precertification Nurse is to perform Pre-Certification determining the medical necessity of requested services for New Jersey Auto No-Fault injuries.

Qualifications

• New Jersey Auto PIP / No-Fault - Preferred
• InterQual/Review Manager/CERME
• CPT and ICD-9/ICD-10 diagnosis coding
• Medical management related to auto claims – Preferred
• Microsoft Office Suite programs
• Structure and content of the English language including the meaning and spelling of words, rules of composition and grammar

Requirements

• Strong interpersonal skills, communication and presentation
• Ability to use logic and reasoning to identify appropriate alternative course of care based on individual clinical outcomes
• Ability to work independently
• Ability to provide instruction and direction to support staff
• Will be required to have the ability to educate patients and the provider community regarding the Pre-Certification process and its governing laws
• Must be detail oriented and able to multi-task
• Must be able to type 45-50 words per minute

Experience

• 3 Years Med-Surg – Required
• Utilization Review – Preferred
• Ortho/Rehab – Preferred

Job Type

• Full Time; home based

Required Education

• Graduate of an accredited school of nursing

Required License or certification

• Active Nursing License in good standing – LPN/RN