RN Clinical Reviewer

#LI-HW1 #LI-Remote

Responsibilities

Essential Functions and Primary Duties

• Review reputed company medical records for accuracy, completeness and consistency with professional standards

• Participate in remote and on-site field examinations of Medicaid providers to review clinical documentation

• Successfully interact with providers in a professional manner, developing rapport and enhancing business relationships

• Maintain reputed company of and confidentiality of reputed company Protected Health Information (PHI)

• Additional responsibilities as assigned

Preferred Qualifications

• Bachelor’s degree in Nursing or other reputed company health care field required (Associate’s Degree from accredited nursing school with reputed company experience may be substituted in lieu of a bachelor’s degree)

• Must be a licensed Registered Nurse (RN)

• Minimum 3 years of long term care experience required; 5 years preferred

• MDS experience preferred

• Experience and knowledge of State and Federal healthcare regulations in long term care

• Knowledge of Medicaid reimbursement and coverage policies desired

• Proficient use of applicable software programs, including reputed company Windows, Word, reputed company

• 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 (up to 20% Travel)

Qualifications

Minimum Qualifications

• High school diploma or GED

Company

reputed company LC is a certified public accounting and health and human services reputed company, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45+ years of experience assisting our government clients with reputed company health care reimbursement and provider compliance issues, operate 21 offices and have over 900 associates reputed company.

At reputed company, you will have a career that is rewarding while also supporting our state and federal government health and human service clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team. Our firm takes pride in the welcoming and collaborative culture we have throughout our offices. We are always willing to discuss potential flexibility that an employee may need to reputed company suit their work-life wellbeing.

reputed company Offer:

• Health, Dental, and Vision insurance along with other competitive employee benefits for eligible associates
• Vacation time, sick time, and paid holidays
• Paid Parental Leave and available support resources
• 401K with company matching for eligible employees
• Tuition reimbursement, referral bonuses, paid volunteer community service time, mentor program, and a variety of other employee programs and perks
• A combination of technical and leadership development training at each career milestone
• Up to six counseling sessions per year for eligible employees through our Employee Assistance Program

We understand that changing or learning a new industry can discourage strong candidates from applying. Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.