State Licensed Clinical Claims Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025
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Job Description:
A company is looking for a Clinical Claims Nurse.
Key Responsibilities
Analyze medical records and case files to produce objective
summaries for reconsideration or dispute resolution
Make evidence-based decisions in compliance with legal statutes,
regulations, and clinical standards
Address issues presented by patients, beneficiaries, or healthcare
providers involved in appeals or disputes
Required Qualifications
Associate's degree or higher in a healthcare-related field from an
accredited institution
LPN or RN License
Minimum of three (3) years' experience in medical appeals, dispute
resolution, or clinical review
Background in Nursing, Physical Therapy, Occupational Therapy, or
Respiratory Therapy
Possession of a coding certification is a plus
Keywords: VirtualVocations, Los Angeles , State Licensed Clinical Claims Nurse, Healthcare , Vista, California
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