Precertification Nurse (Remote - East coast)

About the role

The Precertification Nurse role at Medlogix, LLC involves performing Pre-Certification to determine the medical necessity of requested services for New Jersey Auto No-Fault injuries. This position requires a strong understanding of New Jersey Auto PIP/No-Fault, InterQual/Review Manager/CERMEC, and ICD-9/ICD-10 diagnosis coding.

Responsibilities

• Determine the medical necessity of requested services for New Jersey Auto No-Fault injuries
• Work independently and provide instruction and direction to support staff
• Educate patients and the provider community regarding the Pre-Certification process and its governing laws
• Ensure compliance with relevant laws and regulations

Requirements

• Graduate of an accredited school of nursing
• Active New Jersey State Nursing License in good standing – LPN/RN
• 3 years of Med-Surg experience
• Preferred experience in Utilization Review, Ortho/Rehab
• Strong interpersonal skills, communication, and presentation abilities
• Detail-oriented and able to multi-task
• Able to type 45-50 words per minute

Qualifications

• Knowledge of Structure and content of the English language including the meaning and spelling of words, rules of composition and grammar

Skills

• Strong interpersonal skills, communication and presentation
• Ability to use logic and reasoning to identify appropriate alternative course of care based on individual clinical outcomes
• Ability to work independently
• Ability to provide instruction and direction to support staff
• Ability to educate patients and the provider community regarding the Pre-Certification process and its governing laws

Benefits

Medlogix offers a competitive benefits package including health insurance, retirement plans, and paid time off.

Pay

Compensation is commensurate with experience.

Schedule

The role is full-time, Monday to Friday, with occasional travel to Hamilton, NJ for training.