Nevada Licensed Nurse Educator

Job Summary

A company is looking for a Nurse Educator/Review Coordinator.

Key Responsibilities

• Facilitate provider education related to claim reviews and Medicare policies
• Collaborate with management to identify billing issues and improve provider compliance
• Conduct desktop medical reviews and support physician reviewers with case summaries

Required Qualifications

• Graduation from an accredited school of nursing and current RN licensure or equivalent qualifications
• Experience in Medicare QIO claim reviews or medical reviews for MAC or RAC appeals
• Knowledge of ICD-10-CM/PCS coding rules and DRG assignment
• Clinical background in healthcare-related fields preferred
• Ability to maintain confidentiality in compliance with HIPAA and HITECH regulations