HCSC
Medical Review II
This job is now closed
Job Description
- Req#: R0035151
Registered Nurse with current, active, unrestricted Registered Nurse (RN) license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire.
3 years clinical experience.
Verbal and written communications skills.
Analytical and decision making skills.
Customer Service
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position is responsible for performing accurate and timely medical review of regular business, state of Texas and national accounts claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from providers or members concerning medical determinations.JOB REQUIREMENTS:
This position is REMOTE
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$58,800.00 - $130,100.00About the company
Health Care Service Corporation (HCSC) is the largest member-owned health insurance company in the United States. HCSC offers a wide variety of insurance products and related services through Blue Cross and Blue Shield® of Illinois, Blue Cross and Bl...
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