Medical Record Review Nurse - Utilization Review Regist. Nurse - Long Beach CA

Company: Cybercoders.com
Location: Long Beach, CA
Posted On: 11/05/2009

<P>Medical Record Review Nurse - Utilization Review Regist. Nurse Medical Record Review Nurse - Utilization Review Registered Nurse - Medical Claims Auditing Nurse </P> <P>Skills Required - Registered Nurse, Medical Record Review, Utilization Review, Risk Pool Handling, Medical Claims Processing, Medical Claims Auditing, Medical Claims Resolutions<BR><BR>Medical Record Review Nurse - Utilization Review RN<BR><BR>If you are a Registered Nurse with at least one year of experience in utilization review or a managed setting, please read on!<BR><BR>What you need for this position:<BR><BR>* Licensure as a Registered Nurse<BR>* At least one year of experience in utilization review or a managed setting<BR>* Risk pool handling experience is required <BR><BR>What you'll be doing:<BR><BR>* Resolve, audit, process claims for clinically related issues<BR>* Review, process, audit claims for payment and appropriateness of charges<BR>* Screen, audit, process claims of specific criteria for appropriate payment <BR>* Visit providers as necessary to compare billed charges to medical record<BR>* Support Accounting Dept. to determine liability for out-of-plan medical services<BR>* Perform special projects, reconciliations, research, and analysis relating to utilization and cost of medical services<BR>* Recommend/implement innovative strategies to retain members, contain medical costs, and improve efficiency<BR><BR>What's in it for you:<BR><BR>* Competitive salary<BR>* Great Benefits package<BR><BR>So, if you are a Registered Nurse with at least one year of experience in utilization review or a managed setting, please apply today! </P>df-lj More...

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