Medical Review Nurse (RN)- Post Appeals (must be licensed in Illinois)

Company: Molina Healthcare | Salary: $31 to $59 per hour | Employment: Full-time | License: RN | State licensure: Illinois

Job Description Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.