A provider of enterprise solutions and services is seeking a Telecommute Medical Review Specialist III. Core Responsibilities of this position include: Performing comprehensive medical record and claims review Utilizing electronic health information imaging and inputting medical review decisions Utilizing internet and intranet sources for policy verification Skills and Requirements Include: Must have and maintain a valid state driver's license for the state of residence 3 years clinical experience as a Registered Nurse 4 years federal and local policy applications in relation to insurance procedures for medical necessity Current licensure as a Registered Nurse in one or more of the 50 states or DC Ability to keep sensitive and confidential material private Must have no adverse actions pending or taken against him/her by any State or Federal licensing board