South Carolina Licensed Clinical Reviewer

A company is looking for a Clinical Reviewer - RN - Part-time (Remote U.S.) to join their team.

Key Responsibilities

Review and interpret patient records to assess medical necessity and appropriateness of care

Initiate referrals to physician consultants and process their decisions regarding service denials

Ensure accurate and timely submission of all administrative and review-related documents

Required Qualifications

Active, unrestricted Registered Nurse (RN) License in South Carolina or an RN compact state license

Associate's or Bachelor's degree (or Diploma) in Nursing

2+ years of clinical experience in an acute or med-surgical environment

1+ years of knowledge of medical records, medical terminology, and disease process organization