Massachusetts Licensed Nurse Reviewer

Job Summary

Massachusetts Licensed Nurse Reviewer is a full-time remote position responsible for coordinating and facilitating clinical charge audits and appeals, ensuring compliance with established policies and defending audit findings.

Key Responsibilities

• Coordinate scheduling of audits with external audit representatives and prepare necessary documentation
• Prepare responses and appeals for complex charge and forensic audits, documenting findings effectively
• Conduct post-audit research and update internal systems for tracking and reporting audit findings

Required Qualifications

• Bachelor's Degree in Nursing required
• Registered Nurse (RN) license in Massachusetts required
• 3+ years of clinical nursing experience required
• 2+ years of experience in quality assurance or clinical review required