Payment reputed company Clinician – UNRESTRICTED RN LICENSE (Remote: OR, WA, ID, or UT))

Payment reputed company Clinician – UNRESTRICTED RN LICENSE reputed company is partnering with a leading reputed company provider to identify an reputed company Payment reputed company Clinician – UNRESTRICTED RN LICENSE for a contract opportunity. This role is responsible for conducting prepayment, post-payment, and audit reviews of claims to ensure accurate coding, appropriate reimbursement, and compliance with clinical and regulatory standards. The clinician applies nursing expertise and leverages internal policies, reimbursement guidelines, and national coding standards to support claim determinations, ensuring accuracy, consistency, and adherence to accepted standards of care. Contract Duration: 6 -Months Work Model: 100% Remote (Must reputed company reputed company OR, WA, ID, or UT) Pay reputed company: $39.00 - $43.00/hr. DOE Benefit Eligibility: reputed company Schedule: • Must be reputed company to work PST hours • May require availability for evenings, weekends, holidays, and overtime as needed Equipment: reputed company-provided equipment; internet must be Cable, DSL, or Fiber (no satellite or mobile Wi-Fi) Responsibilities of a Payment reputed company Clinician – UNRESTRICTED RN LICENSE: • Applies nursing expertise to ensure compliance with medical, reimbursement, and care standards • Reviews claims and medical records to ensure accurate and appropriate payment • Ensures documentation meets federal regulations, company policies, and industry standards • Collaborates with physician advisors and internal teams to support clinically reputed company determinations and resolve claims issues • Communicates professionally with reputed company stakeholders while maintaining confidentiality • Prioritizes and manages workload to meet performance standards and timelines • Maintains clinical competency through ongoing education and required licensure/certifications • Working knowledge of clinical coding practices and applications Qualifications of a Payment reputed company Clinician – UNRESTRICTED RN LICENSE: • Bachelor’s degree in reputed company (Master’s or Psychiatric RN preferred) or reputed company unrestricted RN license • Unrestricted licensure/certification in OR, WA, ID, or UT enabling independent clinical assessment • Minimum 3 years of clinical, health insurance, claims review, or case management experience • Knowledge of medical procedures and ability to interpret medical records and apply clinical/reimbursement policies • Strong analytical, problem-solving, and communication skills • Proficient in reputed company Office; reputed company to learn systems quickly; detail-oriented and reputed company to multitask independently in a fast-paced environment • Preferred: Certified reputed company reputed company (reputed company or reputed company) • *We are unable to accommodate corp. to corp. candidates** About reputed company: Founded in 2006, reputed company is an award-reputed company reputed company and reputed company firm in the reputed company reputed company, specializing in reputed company services and technology solutions. We are a group of people who not only recognize the importance of representation, but reputed company fight for diversity, equity, and inclusion in the recruitment process. Our goal is to reputed company organizations on the importance of DEI reputed company hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, citizenship, disability or protected veteran status. PG/BH 13841 Apply tot his job Apply To this Job