Registered Nurse, Insurance Audit & Compliance Specialist

Registered Nurse, Insurance Audit & Compliance Specialist

About this role

Healthcare Staffing Professionals has an immediate need for a Registered Nurse, EHR Audit Specialist to work in nursing homes located throughout the Twin Cities area. This position is full-time but will consider part-time. The assignment is expected to last approximately 3–5 months, with anticipated completion by December 31, 2026. Flexible schedules may be possible. The ideal candidate will p rovide surveillance, consultation, guidance, audits and evaluation of health care providers to assure a level of quality care based upon compliance with State laws and rules.

Pay Rate : $75/hr

Location : nursing homes in the Twin Cities area

Job Duties :

• To evaluate and conduct audits on providers to ensure a level of compliance with State laws and rules
• To compile and record the information gathered and document conclusions reached and ascertain the degree of compliance with regulations.
• To make periodic unannounced or announced follow-up site visits to ascertain compliance with correction orders previously issued or as an expanded pool audit is determined necessary.
• To attend legal proceedings regarding correction orders, issuance of penalty assessments, so that all matters and concerns therein will be properly presented and clarified.
• Other duties as assigned.

Requirements :

• Strong knowledge of clinical health care.
• Knowledge to complete assessment and analysis of client/resident data, application of theory, nursing techniques and effects on client outcomes.
• Thorough knowledge of the evaluative processes of State laws and regulations.
• Ability to interpret laws and regulations to make decisions about clinically related issues to defend legal actions.
• Strong writing skills, sufficient to write reports and document issues following the Principles of Documentation.
• Skilled in interviewing providers, clients/residents, case managers, etc. to obtain information needed to make decisions.
• Ability to manage a heavy workload and be able to prioritize work.
• Ability to use multiple software platforms, databases and programs.

Interpersonal skills:

• objectivity, self-motivation, self-reliance, ability to communicate and work with all levels of personnel and management.
• ability to establish effective working relationships and be a good listener.
• adaptability, self-assuredness, decisiveness and ability to deal with disagreement and dissatisfaction.

Technical skills: Licensed as a Registered Nurse, or other allied health professional.

• Basic Life: $25,000 (100% employer paid)
• Basic Accidental Death and Dismemberment (AD&D) : $25,000 (100% employer paid)
• Voluntary Life/AD&D: Additional coverage options available for employees, spouses and children (100% employee paid)
• Company 401(k)plans with eligibility from the 1 st day of the month following hire.
• Dedicated Administrative Support Staff

With Anthem's Sydney app, you can take better care of yourself with features that focus on your wellness, such as:

• Community Resources
• Health Assessment
• Diabetes Prevention through Lark

Additional Resources

• Employee Assistance Program (EAP): Counseling, legal consultations, financial planning, and identity theft recovery
• 24/7 Nurseline for health-related inquiries
• Rula Mental Health Support: Therapy and psychiatry services
• Travel Assistance Program: Medical support and emergency assistance while traveling
• BenefitHub and LifeMart Discounts: Access to discounts on travel, shopping, Pet Insurance, movie tickets, flight and more
• Access HSP's wide range of wellness resources through Anthem's wellness portal.

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law.

TrueBlue, Inc. And its brands welcome and encourage applications from candidates with disabilities. Accommodations are available upon request for candidates taking part in the application or interview process. If you require disability-related accommodation during the application or interview process, please contact your recruiter directly, employee relations at View email address on click.appcast.io , or View phone number on click.appcast.io. TrueBlue, Inc. And its brands will consult with all applicants who request disability-related accommodation during the application or interview process to ensure that the accommodation provided takes into account the applications individual accessibility needs.

You must be work authorized in the United States on a full time basis without the need for employer sponsorship now or in the future. The Company cannot offer employment to F-1 (student) visa holders who require sponsorship (including but not limited to STEM OPT extensions) in the future or cannot work now on a full time basis.