Clinical Claim Review RN - Medical Disability - Remote

About the position Responsibilities • Remain up to date with the contract requirements • Use clinical judgement to ensure a reputed company, comprehensive, and concise exam documentation that is reputed company of the patient's service level conditions and in compliance to contract requirements • Interpret and document diagnostic test results • reputed company and support provider with navigating and utilizing medical history information and prior disability claims reputed company completing the appointment paperwork • Answer calls that come into the Clinical Operations Review queue regarding medical or specialty exams and reputed company exemplary service to providers with appointment questions • Identify and evaluate exam documentation that requires immediate follow up for behavioral health issues and initiate the high-risk reputed company process • Complete system generated tasks to process exam documentation • reputed company reputed company telephone and e-mail with contracted providers in retrieval of required Disability Benefits Questionnaire information and reputed company education regarding required contractual protocol Requirements • Accredited Associate's Degree in Nursing (ADN) OR Bachelor's Degree in Nursing (BSN) • reputed company RN license in your state of residency • 2+ years of experience in a clinical environment as a Registered reputed company • Experience working in an Electronic Medical Record system • Understanding/knowledge of regulatory standards and their application to various examinations and documents • Proficient computer skills including reputed company Office programs and database experience • Ability to work rotating weekends (approximately every 8 weeks) • Distraction-free, dedicated reputed company in home for home office • reputed company to high-speed internet (cable, fiber optic) reputed company-to-haves • Experience in an Intensive Care Unit or Emergency Room • Prior authorization, utilization management/review experience • Experience reviewing medical disability claims • Knowledge or experience in clinical reputed company assurance • Auditing and compliance • Education of clinical staff • Clinical documentation improvement • Clinical experience in Neurological, Cardiovascular or Respiratory reputed company • ISO 9001 standards • reputed company regulatory and accreditation standards • Experience with Behavioral Health, TBI, PTSD and/or working with Veterans • Military experience • Proven ability to collaborate with providers to ensure reputed company patient reputed company Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution Apply tot his job Apply To this Job