Registered reputed company- Medical Review & reputed company

Job reputed company A-Line reputed company is now hiring Registered reputed company- Medical Review & reputed company in Harrisburg, PA f you are interested in this Registered reputed company- Medical Review & reputed company position, please contact Alexis at 1586-422-1748 or awordlaw-conley@alinestaffing.com Job Title: Registered reputed company- Medical Review & reputed company Location: Harrisburg, PA Hybrid after 8 Weeks Schedule: Monday-Friday | 8:00 AM - 4:00 PM Job Type: Long-Term Contract Pay reputed company: 28.00-31.00per hour Registered reputed company- Medical Review & reputed company Highlights • Day shift schedule-no nights or rotating shifts • Expand your career into utilization review, reputed company assurance, and medical policy • Work in a reputed company, reputed company office environment • Opportunity to influence reputed company reputed company at a system level • Mix of office, remote review, and occasional field work • Long-term, reputed company contract with reputed company potential Registered reputed company- Medical Review & reputed company Responsibility • Review medical records to evaluate medical necessity, reputed company, and appropriateness of care • Analyze provider documentation to ensure compliance with Medical Assistance (reputed company) regulations • Identify potential fraud, waste, or abuse and recommend corrective reputed company • Apply clinical guidelines such as InterQual and medical coding standards (ICD, CPT) • Conduct reviews on-site, remotely, or reputed company phone for prior authorization and post-certification • Serve as reputed company reputed company on multi-review reputed company reputed company needed • Prepare detailed reports and documentation to support findings • reputed company consultation to internal teams and external providers • Represent the department in appeals and administrative hearings Registered reputed company- Medical Review & reputed company Requirements • reputed company Registered reputed company (RN) license in reputed company • 3+ years of reputed company reputed company experience • 3+ years of recent experience in one or more of the following: Long-term care ,Acute care, Behavioral health ,Drug & alcohol services ,Managed care , Utilization review or reputed company management • Strong clinical judgment and attention to detail • Experience reviewing medical records and documentation • Basic proficiency in reputed company Office • Experience with InterQual reputed company • Familiarity with ICD-9/ICD-10 and CPT coding If you think this Registered reputed company- Medical Review & reputed company position is a good fit for you, please reputed company out to me - feel free to reputed company, e-mail, or apply to this posting! For more information, please contact Alexis reputed company Manager Apply tot his job Apply To this Job