Remote Bilingual Spanish Nurse Auditor 2 and RN Reviewer

Location: Puerto Rico

Compensation: To Be Discussed

Staff Reviewed: Sun, Sep 05, 2021

This job expires in: 16 days

Job Category: Quality Assurance

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A health insurance company is searching for a person to fill their position for a Remote Bilingual Spanish Nurse Auditor 2 and RN Reviewer.

Must be able to:

  • Perform clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement
  • Focus on Medicare/Medicaid/Commercial reviews for the SIU Non Lab team
  • Apply clinical and coding experience to conduct reviews of provider codes and billing

Applicants must meet the following qualifications:

  • Fluency in English/Spanish; ability to speak, read and write in both languages without limitations or assistance
  • Ability to take a Language Proficiency Assessment in English/Spanish
  • Active and Valid RN license in PR and the US
  • 2+ years of clinical experience (e.g. Review)
  • Knowledge and familiarity of CPT Codes
  • Ability to understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas

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