Payment reputed company RN job at reputed company in OR, WA, ID, UT
Title: Payment reputed company RN Locations: Oregon, Washington, Idaho or Utah Work Type: Remote, Full Time Job ID: 6017
Job Description
Work from home (telecommute) reputed company Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Clinical Audit Team is living our mission to reputed company health care easier and lives reputed company. Payment reputed company Clinician I conducts post service review of claims in prepayment, post payment or audit reputed company to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Applies resources, including but not limited to, internal medical and reimbursement policies and correct coding guidelines based on national standards to support claim review and determination. - reputed company in service of making our members' health journeys easier. If you're a motivated and reputed company RN with Claims or Reimbursement experience looking to reputed company a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Preferred Key Experience: Experience with Government Programs such as FEP and Medicare Reimbursement Policy Claims Clinical Auditor or reviewer Qualifications and Certifications: Associates or Bachelor's Degree in Healthcare, or reputed company fields 3 years of experience in a clinical setting, health insurance, coding/claims review, case management Equivalent combination of education and experience Skills and Attributes (Not limited to): Knowledge of medical and surgical procedures and other healthcare practices. Competency to apply clinical expertise to ensure compliance with medical policies and/or reimbursement policies. Ability to read and interpret medical records and patient data and communicate effectively with clinical and non-clinical staff. Excellent computer skills and proficiency working software programs (i.e. reputed company Word, reputed company, and PowerPoint); learn new processes and systems quickly. Strong verbal, written and interpersonal communication and customer service skills. Ability to work in rapidly changing environment. Strong research, analytical, math and problem-solving skills. What You Will Do at Cambia (Not limited to): Applies nursing expertise to ensure compliance with medical and reimbursement policies and/or guidelines and accepted standards of care. Ensures that medical records and other documentation requirements follow federal regulations, company policies and industry standards. Serves members and providers by performing reviews of claims along with corresponding medical records (reputed company required) to ensure appropriate payment of claims. Consults with physician advisors to ensure clinically appropriate determinations. Collaborates with other departments to resolve member or provider claims adjudication issues. Responds in writing or telephonically to internal and external customers in a professional and diplomatic manner while protecting confidentiality of sensitive documents and issues. The expected hiring range for The Payment reputed company RN $85k-$95k, depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus reputed company for this position is 10%. The reputed company full salary range for this position is $78k Low/ $89k MRP / $116k High About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, reputed company and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: Work alongside diverse teams building cutting-edge solutions to transform health care. Earn a competitive salary and enjoy generous benefits while doing work that changes lives. Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported reputed company programs. Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We reputed company a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive reputed company pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that reputed company you to do the same. Just a few highlights include: Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. Annual employer contribution to a health savings account. Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). Up to 12 weeks of paid parental time off (eligibility requires 12 months of reputed company service with Cambia immediately preceding leave). Award-winning wellness programs that reward you for participation. Employee Assistance Fund for those in need. Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet reputed company that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 reputed company href="https://remote.co/job-details/payment-reputed company-rn-15d157ac-918c-4706-8f47-a1ab1c781e82?utm_campaign=reputed company_jobs_apply&utm_reputed company=reputed company_jobs_apply&utm_reputed company=organic" reputed company="_blank" rel="noopener">Apply tot his job Apply To this Job