Medical Claims Reviewer

Emploi pas sur LinkedIn

🕒 il y a 17 jours

🇺🇸 États-Unis – Télétravail

💵 $31 250 - $32 500 / an

⏳ Contrat

🟡 Intermédiaire

🟠 Senior

🔍🏥 Relecteur Médical

👻 Score fantôme 12%

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🗣️🇺🇸🇬🇧 Anglais requis

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Simsy Ventures

11 - 50 employés

Fondée en 2022

💼 Conseil

📣 Marketing

🏥 Santé

Consulting • Marketing • Healthcare

Simsy Ventures est un créateur d'entreprises et co-fondateur institutionnel qui s'associe avec des entrepreneurs, des investisseurs et des sociétés pour créer des startups durables. Leur mission se concentre sur la capacité des startups à atteindre leur véritable potentiel tout en favorisant un impact positif sur les profits, les personnes et la planète. Grâce à une approche structurée, ils soutiennent les startups tout au long de leur cycle de vie, de l'idéation à la validation du marché et à la croissance. En s'appuyant sur un modèle de studio de capital-risque réplicable, Simsy Ventures vise à dynamiser les économies mondialement à travers un entrepreneuriat impactant.

Description

• Conduct ESRD medical record reviews comparing medical record documentation to EQRS and NHSN to determine accuracy and timely reporting • Determine and classify discrepancies based on the type and severity of errors, including missing data, incorrect values, and data entered in the wrong fields • Participate in quality control activities to support corporate and team objectives • Assist with special projects or responsibilities as assigned by management

🎯 Exigences

• Active, unrestricted RN licensure in the United States and in the state of hire OR active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact • Associate Degree in Nursing OR graduate of an accredited School of Nursing • Two years of clinical experience plus two years of experience with utilization/medical review, quality assurance or end stage renal disease/dialysis • Strong clinical background in dialysis, managed care, home health, rehabilitation, and/or medical-surgical settings • Knowledge of specific criteria/protocol sets and the ability to use them effectively • Proficiency with word processing software and Microsoft Office • Ability to work independently, prioritize tasks, and make sound decisions • Excellent customer service, communication, organizational, and critical thinking skills • Ability to handle confidential information with discretion • Proficient with computers, including the ability to use multiple screens and programs simultaneously • High-speed internet (non-satellite) and a private, lockable home office • Background check and drug testing prior to the start of employment; some positions may require fingerprinting

🏖️ Avantages

• 401(k) and company match • PTO that grows the longer you stay • Health, Vision, Dental • Company provided Life Insurance and Voluntary Life Insurance • Short Term Disability and Long Term Disability

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