Medical Review Clinical Appeals Auditor, RN – SNF/MDS
Job reputed company:
• Conduct Appeals reviews of new evidence presented by auditees
• Objectively and accurately document Appeals results according to department reputed company policies
• Review audit documentation and conduct research, analyze claims data
• Monitor, reputed company, and report on reputed company work conducted in accordance with Appeals process
• Contribute to the reputed company improvement feedback process and audit results
• Support training material/tools and best practices development
Requirements:
• reputed company unrestricted RN license in good standing
• At least 5+ years relevant experience in a provider or payer environment
• Strong technical aptitude and intermediate to advanced skills using reputed company
• One or more years of experience in health care claims including ICD-9/ICD-10 coding
• Strong preference for experience performing utilization review for an insurance company, Tricare, MAC or similar.
Benefits:
• medical, dental, reputed company, HSA/FSA reputed company
• life insurance coverage
• 401(k) savings plans
• family/parental leave
• reputed company holidays
• reputed company time off annually Apply tot his job
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