RN Clinical Reviewer
Location: Indianapolis Indiana
Description: Briljent is at the momment seeking for RN Clinical Reviewer right now, this vacancy will be placed in Indiana. Further informations about this vacancy opportunity kindly read the description below. Immediate Need: One-Month, Full TimeThe RN Clinical Reviewer will independently review quality incentive metrics and medical records relating to Medicaid engagements. Essential Functions: Perf! orm various assignments relating to Medicaid provider quality incentive programs Review medical records for accuracy, completeness and consistency with professional standards Participate in on-site field examinations of Medicaid providers to review clinical documentation Work closely with accounting staff and state client personnel on health care reimbursement related issues Develop and maintain general knowledge of Medicaid statutes, regulations, provider billing manuals and other Medicaid policies Interpret and analyze health care data Successfully interact with accounting staff, state agency staff and providers in a professional manner, developing rapport and enhancing business relationships Maintain security of and confidentiality of all protected health information Additional responsibilities as assigned Requirements: Bachelor's degree in Nursing Be a Licensed Registered Nurse Minimum 3 years of clinical review experience Certified Professional Coder (CPC) a plus Have ! understanding of healthcare claims, Current Procedural Termino! logy (CPT), International Classification of Disease (ICD), Healthcare Common Procedure Coding (HCPC) code sets Experience and knowledge of State and Federal healthcare regulations Proficient use of applicable software programs, including Microsoft Windows, Word, Excel Strong analytical and problem solving skills Strong verbal and written communication skills Ability to manage multiple deadlines and prioritize assignments Ability to work in a team environment Well organized with a high degree of accuracy and attention to detail Must be able to travel based on client and business needs Physical Requirements Environmental Conditions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly requir! ed to sit and use hands to handle, or feel objects, a keyboard and other office equipment.
The employee frequently is required to sit in meetings for long periods of time, to travel frequently via commercial airliner and automobile, and to utilize technology tools for extended via laptop for extended periods of time. The employee must be able to reach with hands and arms and talk or hear. Specific vision abilities required by this position include close vision, color vision, and the ability to adjust focus. The noise level in the work environment is usually moderate.
Briljent will not discriminate against any employee or applicant because of age, color, gender, marital status, national origin, race, religion, sexual orientation, veteran status, disability status (in compliance with the Americans with Disabilities Act) or other status protected by applicable law.
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If you were eligible to this vacancy, please email us your resume, with salary! requirements and a resume to Briljent.
If you interested on this vacancy just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Wed, 16 Oct 2013 03:37:15 GMT
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