RN - Clinical Data Services Rep REMOTE
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Job Location:
Monthly Salary:
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
We have built our reputation on partnering with our clients and candidates to achieve the desired results. Our recruiting professionals have extensive experience matching the right candidate to the right client for the right position. We provide the best opportunities to the most talented candidates in a multitude of industries.
MMC is a privately owned business with corporate headquarters in Irving Texas. With 2000 employees working in 40 states MMC is able to support all United States locations and some international locations.
We appreciate your interest in reviewing this particular position and we encourage you to visit our website where you can always search and apply for opportunities at
MMC strives to ensure all job posting confirm details of the position the rate of pay and acknowledge medical benefits are offered.
Get started on your career journey today! Apply to become a part of the MMC Team!
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability status protected veteran status or any other characteristic protected by compliance with federal law all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.
Job Title:RN Clinical Data Services Representative
Pay Rate:$42.31/hour
Location: Austin TX (Local candidates preferred) - Remote
Visa Status: No restrictions
About the Role
We are seeking a skilled Clinical Data Services Representative to join our team. This role is ideal for an experienced RN who is passionate about promoting quality outcomes ensuring medical necessity and driving cost-effective care delivery. This is not a direct patient care position.
Shift Requirements:
- Must be able to work the 10:00 AM - 7:00 PM shift.
- Standard 8-hour shifts unless overtime is needed and approved.
- Flexibility required to work any shift between 7:00 AM - 7:00 PM.
Key Responsibilities
- Conduct pre-service concurrent and retrospective reviews.
- Collaborate with healthcare providers to ensure quality member outcomes.
- Assess the medical necessity of outpatient and out-of-network services.
- Evaluate the appropriateness of treatment settings within professional limitations.
- Promote optimal use of member benefits and effective resource management.
- Apply knowledge of the Texas Administrative Code (TAC) to ensure compliance.
Required Skills & Experience
- Registered Nurse (RN)with 3 years of experience.
- Familiarity with Texas Administrative Code (TAC) requirements.
- Strong knowledge of Medical Necessity standards.
- Proficiency in Microsoft Word and Excel.
Preferred Skills:
- Additional experience in advanced Excel functions.
- Prior experience in utilization review or clinical data analysis.
What We Offer
- Competitive pay at $42.31 per hour.
- Opportunity to work remotely while supporting a leading healthcare program.
- Professional growth in a collaborative compliance-driven environment.
Key Skills
- Hp Unix
- Administration & Operation
- Ado
- IT Security
- Management Administration
About Company
MMC provides professional services and workforce management services and solutions (both technical and non-technical) to public and private companies in addition to governmental organizations (Federal, State and Local) in the United States. Our Partners include major systems integrato ... View more
