RN / Medical Reviewer / Utilization Review / LPN

RN/Medical Reviewer Kelly Services has an exciting opportunity available for a RN/Medical Reviewer to join our client located in Wilkes-Barre, PA! As the Medical Reviewer, you'll be reviewing and auditing medical records for completeness and accuracy by looking at various pieces of documentation.
If records are missing important information it will be your duty to ensure that the information is included and the record is up to compliance.
So, if you're ready to make certain that all medical records are complete and accurate, then apply now to begin the recruiting process today!ROLES AND Responsibilities:
Manage and coordinate care for members ensuring delivery of appropriate health care services.
Clinical review to ensure that medical necessity, cost effectiveness, and quality of care are provided to the member.
Understanding of benefits, contractual agreements and regulatory guidelines essential.
Responsible for these determinations and will act as a liaison with the member, provider, and many internal departments within the company.
REQUIRED Qualifications:
Utilization Management experience preferred 5 years clinical experience Knowledge of ICD9/CPT coding desired Active RN license in the state of Pennsylvania required (LPN's will be considered) HOW TO APPLY:
This position is recruited for by a remote Kelly office, not your local Kelly branch.
To apply for this opportunity please utilize the "Apply Now/Submit Resume" button.
Every day, Kelly Healthcare Resources (KHR) specializes in providing highly skilled nursing and allied health professionals within hospitals and other health care facilities, as well as positions in sectors such as insurance, pharmaceutical, health management and education.
In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect:
Competitive pay Access to a comprehensive employee benefits package including health, prescription, vision, dental, and life and short-term disability insurance Paid service bonus and holidays Portable 401(k) plans Recognition and incentive programs Access to continuing education via the Kelly Learning Center Related Search Terms:
Field nurse, field registered nurse, field nurse case manager, home health field RN, RN, registered nurse, field case manager Why Kelly ?With Kelly, you'll have direct connections to leading healthcare companies'providing you with the chance to positively impact quality and delivery of patient care.
In a field where innovation and change happen constantly, our connections and opportunities will help you take your career exactly where you want to.
We work with 97 of the Fortune 100 companies, and more than 1,200 healthcare hiring managers turn to us each year to access the best talent:
people like you.
Let us help advance your healthcare career today.
About Kelly Services Kelly Services, Inc.
KELYA, KELYB) is a global leader in providing workforce solutions.
Kelly offers a comprehensive array of outsourcing and consulting services as well as world-class staffing on a temporary, temporary-to-hire, and direct-hire basis.
Serving clients around the world, Kelly provided employment to more than 555,000 employees in 2014.
Revenue in 2014 was $5.
6 billion.
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com and connect with us on Facebook , LinkedIn and Twitter .
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