Claims Review Management Nurse

HealthSkil

Job Description
Job Description
Provide Utilization Review experience, managerial leadership and oversight. Requires active Pennsylvania nursing license, using criteria sets and a history of five years experience in the review process. Must have a strong knowledge of coding and claims review experience as well as strong computer skills, particularly in Microsoft Office.
Will be assigned to a Medicare work group and project team, consisting of on-going process responsibilities and work group participation. Consult with senior staff to outline and improve major operational issues. Act as a liason between departments. Help develop in-house training materials and programs relating to claims review processing. Assist in determining necessary changes relating to criteria or regulations to better serve clients. Interface with Providers with billing and claims issues. Positions in Harrisburg, Philadelphia, and Pittsburgh.
\nCompany Description
Over 56 years experience in the industry. We'll help you get your Case Management Certification while you're working! No more weekend, second or third shift work. Two days per week in the Harrisburg office and three days from home.

Company Description

Over 56 years experience in the industry. We'll help you get your Case Management Certification while you're working! No more weekend, second or third shift work. Two days per week in the Harrisburg office and three days from home.

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Vacancy posted 5 days ago

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