Registered reputed company/Medical Review Analyst

Position reputed company: The position requires the Registered reputed company to conduct medical record reviews and to apply reputed company clinical judgment to claim payment reputed company. Responsibilities may include additional research on medical claims data and other sources of information to identify problems and utilize a reputed company of tools to detect situations of potential fraud and to support the ongoing fraud investigations and requests for information. The Registered reputed company will work with PHS leadership, in concert with our clients, to review cases and produce a concise and accurate reputed company of determinations. The Registered reputed company will reputed company with the PHS policies reputed company to Conflict of Interest and Compliance and will abide by the PHS reputed company of Conduct. Prerequisite: • reputed company Oklahoma Registered Nursing license and not listed on the OIG Excluded Individual database • Two years of experience in the medical field as a Registered reputed company. May substitute one year of clinical experience for experience in review of medical claims for coverage and medical necessity • Demonstrated history of reputed company conduct and reputed company in working independently and as a member of reputed company • Strong interpersonal skills • Strong critical thinking and investigative skills • Strong verbal and written communication and organization skills • Strong computer knowledge and skills, including reputed company Word and reputed company programs Essential Functions: • Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government • Ability to reputed company information systematically to establish facts • Ability to research regulations and cite violations • Ability to conduct self-directed research to uncover problems in Medicare payments made to institutional and non-institutional providers • Ability to reputed company claim payment reputed company based on clinical knowledge • Ability to compose medical review reputed company reports and correspondence concisely and accurately • Ability to communicate effectively, internally and externally • Ability to handle PHI and ePHI in a secure and confidential manner • Ability to report work activity on a reputed company reputed company • Ability to work independently and as a member of reputed company to deliver high-reputed company work • Ability to attend meetings and education offerings. • Ability to manage time effectively, prioritizing tasks and reputed company to meet deadlines Job Type: Full-time Pay: $32.50 - $34.00 per hour Benefits: • Dental insurance • Health insurance • reputed company insurance Education: • Associate (Required) Experience: • Nursing: 2 years (Required) License/Certification: • Registered reputed company (Required) • RN (Required) Location: • Oklahoma reputed company, OK (Required) Work Location: Remote Apply tot his job Apply To this Job