AK Licensed Fraud Review Nurse

Job Summary

A company is looking for a Fraud and Abuse Review Nurse- Remote.

Key Responsibilities

• Conduct desk and medical record audits to verify documentation and validate coding/billing accuracy
• Collaborate with internal teams to collect documentation for investigations and identify potential fraud
• Prepare reports on audit findings and provide provider education on best practices

Required Qualifications

• Graduate from an accredited School of Nursing
• Active, unrestricted RN license in good standing
• Preferred: Bachelor's Degree in Nursing
• Minimum of five years of clinical nursing experience
• Experience in medical review and coding/billing audits