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Remote Payment Integrity Registered Nurse

Job is Expired
Location: Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, U.S. Virgin Islands, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Compensation: Salary
Staff Reviewed: Tue, Jul 19, 2022
Job Category: Healthcare
Weekly Hours: Full Time
Employer Type: Employer
Career Level: Experienced
Education Level: Some College, Bachelors

Job Summary

A nonprofit healthcare company has a current position open for a Remote Payment Integrity Registered Nurse.

Candidates will be responsible for the following:

  • Serving members and providers by performing reviews of claims
  • Applying nursing expertise to ensure compliance with medical and reimbursement policies
  • Consulting with physician advisors to ensure clinically appropriate determinations

Skills and Requirements Include:

  • Must have an unrestricted Registered Nurse license within either OR, WA, ID or UT and at least 3 years (or full time equivalent)
  • Knowledge of medical and surgical procedures and other healthcare practices
  • Ability to read and interpret medical records and patient data and communicate effectively with clinical and non-clinical staff
  • Excellent computer skills and proficiency working software programs
  • Strong verbal, written and interpersonal communication and customer service skills
  • Strong research, analytical, math and problem-solving skills

COMPLETE JOB DESCRIPTION

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