RN Clinical Claim Review Nurse

Job Summary

A company is looking for a Clinical Claim Review Nurse - National Remote.

Key Responsibilities

• Conduct forensic reviews and analyze hospital facility bills to determine payment adjustments
• Complete focused reviews of medical records and assist with claims resolution as needed
• Perform research to support audit adjustments and respond to inquiries from team members

Required Qualifications

• High School Diploma/GED (or higher)
• Active and unrestricted RN OR LPN in state of residence
• 2+ years of clinical experience within an acute care setting
• 1+ years of experience working with bill review