• Address: Long Beach, CA 90801 (map)
• Date Posted: 11/07/09
• Job Type: Full-time

Company Cybercoders.com
Position Title Medical Record Review Nurse Utilization Review Regist. Nurse
Job Code 2896680
Job Location Long Beach, CA -
Description




Medical Record Review Nurse - Utilization Review Regist. Nurse Medical Record Review Nurse - Utilization Review Registered Nurse - Medical Claims Auditing Nurse

Skills Required - Registered Nurse, Medical Record Review, Utilization Review, Risk Pool Handling, Medical Claims Processing, Medical Claims Auditing, Medical Claims Resolutions



Medical Record Review Nurse - Utilization Review RN


If you are a Registered Nurse with at least one year of experience in utilization review or a managed setting, please read on!


What you need for this position:


* Licensure as a Registered Nurse

* At least one year of experience in utilization review or a managed setting

* Risk pool handling experience is required


What you'll be doing:


* Resolve, audit, process claims for clinically related issues

* Review, process, audit claims for payment and appropriateness of charges

* Screen, audit, process claims of specific criteria for appropriate payment

* Visit providers as necessary to compare billed charges to medical record

* Support Accounting Dept. to determine liability for out-of-plan medical services

* Perform special projects, reconciliations, research, and analysis relating to utilization and cost of medical services

* Recommend/implement innovative strategies to retain members, contain medical costs, and improve efficiency


What's in it for you:


* Competitive salary

* Great Benefits package


So, if you are a Registered Nurse with at least one year of experience in utilization review or a managed setting, please apply today!

Desired Skills:


Non-Tech Skills:



Pay Rate: $40k - $65k
Start Date: ASAP
Emp. Type: Full Time
# of Openings: 1
Location: Long Beach, CA -
Overtime Pay: None
Job Number: 35819944 : JSRK-MEDICALRECORDREVIEWNURSE_1
Date Posted: 11/5/2009

Cybercoders.com

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