Job Description

Job Description

Job Description

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients’ needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers’ compensation insurance carriers; third party administrators (TPAs); and government entities we serve.

Position: Michigan Utilization Review Nurse (Precertification) - LPN

Location: Remote

FMLA: Non- Exempt, Full-Time

Schedule: M-F 8am-4:30pm

Overview:

The role of Michigan Utilization Review Nurse is to perform Utilization Review determining the medical necessity of services provided for Michigan Auto No-Fault injuries.

Experience Requirements:

1. Knowledge of Michigan PIP / No-Fault - Preferred
2. Knowledge of InterQual/Review Manager/CERME
3. CPT and ICD-9/ICD-10 diagnosis coding - Preferred
4. Medical management related to auto claims – Preferred
5. Utilization Review experience - Preferred
6. Knowledge of Microsoft Office Suite Programs
7. Must have 3-5 years of Med-Surge Experience
8. Must have an active RN / LPN License

Skills:

1. Strong interpersonal skills, communication and presentation
2. Ability to use logic and reasoning to make sound clinical decisions
3. Ability to work independently
4. Ability to provide instruction and direction to support staff
5. Ability to educate patients and the provider community regarding the Michigan UR process and its governing laws
6. Must be detail oriented and able to multi-task
7. Must be able to type 45-50 words per minute

Job Type:

Full Time; home based

Required Education:

Graduate of an accredited school of nursing

Required License or certification:

Active Nursing License in good standing – LPN

EEOC STATEMENT:

Medlogix provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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