Healthcare Claims Examiner, RN Required
Job Description:
• Evaluate appropriateness of beneficiaries' admission to nursing facilities
• Verify documentation of medical necessity for prior approval requests
• Meet performance expectations by completing at least 40 prior approval reviews daily
• Achieve quality assurance reviews with greater than 95% accuracy
• Complete timely reviews within 24 hours
Requirements:
• Active North Carolina Registered Nurse license or Compact license
• At least 2 years of clinical experience
• Knowledge of Microsoft Office and Outlook
• Experience with medical documentation review
• Knowledge of NCTracks and business processes of North Carolina Division of Medicaid preferred
• Clinical medical, surgical and nursing facility experience preferred
• Clinical research experience preferred
Benefits:
• Variety of medical plan options
• 401(k) plan with company match
• Full flex work weeks where possible
• Paid time off including vacation, sick and personal time, and holidays
• Paid parental, military, bereavement and jury duty leave
• 15 days of paid leave per calendar year
• 10 paid holidays per year
• Paid Family Leave program
• Short and long-term disability benefits
• Life and accidental death and dismemberment insurance
• Critical illness and travel accident insurance
Apply Now
Apply Now
• Evaluate appropriateness of beneficiaries' admission to nursing facilities
• Verify documentation of medical necessity for prior approval requests
• Meet performance expectations by completing at least 40 prior approval reviews daily
• Achieve quality assurance reviews with greater than 95% accuracy
• Complete timely reviews within 24 hours
Requirements:
• Active North Carolina Registered Nurse license or Compact license
• At least 2 years of clinical experience
• Knowledge of Microsoft Office and Outlook
• Experience with medical documentation review
• Knowledge of NCTracks and business processes of North Carolina Division of Medicaid preferred
• Clinical medical, surgical and nursing facility experience preferred
• Clinical research experience preferred
Benefits:
• Variety of medical plan options
• 401(k) plan with company match
• Full flex work weeks where possible
• Paid time off including vacation, sick and personal time, and holidays
• Paid parental, military, bereavement and jury duty leave
• 15 days of paid leave per calendar year
• 10 paid holidays per year
• Paid Family Leave program
• Short and long-term disability benefits
• Life and accidental death and dismemberment insurance
• Critical illness and travel accident insurance
Apply Now
Apply Now