RN Review Analyst

Title: Medicare Advantage RN Review AnalystLocation: Detroit, MI (Remote - Must be local to Michigan)Duration: 12+ MonthsRole Type: W2 Contract roleSchedule: Monday - Friday 9-5SUMMARYResponsible for the approval or rejection of claims and/or benefit interpretation. May be required to enter or reference data via PC and/or Clinical Review Team terminal.REQUIREMENTSRegistered Nurse with current Michigan Registered Nurse License.Associate degree or nursing diploma required, bachelor’s degree preferred.Two (2) years RN patient care experience.Triage, case management and/or rehabilitation experience preferred.Medicare Advantage Part B experience a plus.Expertise in the use of medical terminology.Finely honed critical thinking skills are a must.Knowledge of CPT/HCPCS coding and Medicare regulations desirable.CERTIFICATES, LICENSES, REGISTRATIONS Current unrestricted state of Michigan registered nurse license required.