Unfortunately, this job posting is expired.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Related keywords
Some similar recruitments
Home Health Aide-Live In
Recruited by Privatus 8 months ago
Address , Royal
$195 a day
Registered Nurse Home Health
Recruited by AMX Healthcare Inc. 9 months ago
Address , Harrison, 10528
$64 - $69 an hour
Home Health Aide (Hha)- Ny
Recruited by Brandywine Living 9 months ago
Address , Little Neck, 11362
$17 an hour
Medical Review Nurse Auditor
Recruited by Performant Financial Corporation 9 months ago
Address , Remote
Home Health Aide Jobs
Recruited by Amedisys 9 months ago
Address , Cambridge, 21613
$15.67 - $26.11 an hour
Clinical Review Coordinator - National Remote
Recruited by Optum 9 months ago
Address , Dallas, 75202
Medical Review Nurse (Government Outpatient Clinical Focus)
Recruited by Performant Financial Corporation 9 months ago
Address , Remote
Nurse Practitioner, In-Home Health Assessments, 75% Local Travel, 25% Statewide Travel - Faulkner, Pulaski Ar
Recruited by Optum 9 months ago
Address , Little Rock, 72260, Ar
Travel Nurse Rn - Home Health - $2,125 Per Week In Cedar Rapids, Ia
Recruited by TravelNurseSource 9 months ago
Address Cedar Rapids, IA, United States
Home Health Aide Jobs
Recruited by Laurel Circle 9 months ago
Address , Bridgewater, 08807, Nj
$19 an hour
Travel Nurse Rn - Home Health - $2,115 Per Week In Cedar Rapids, Ia
Recruited by TravelNurseSource 9 months ago
Address Cedar Rapids, IA, United States
Home Health Aide (Hha)
Recruited by Nuclear Care Partners 9 months ago
Address Burlington, IA, United States
Home Health Aide - Hha
Recruited by Visiting Angels Cedar Rapids, IA 10 months ago
Address Iowa City, IA, United States
Home Health Aide - Hha
Recruited by Visiting Angels Quad Cities IA 10 months ago
Address Eldridge, IA, United States
Home Care Home Health Aide - Ft8
Recruited by EveryStep 10 months ago
Address Des Moines, IA, United States
Home Health Aide (Hha)
Recruited by Interim HealthCare Inc. 10 months ago
Address Des Moines, IA, United States
Hospice Nurse Residency Jobs
Recruited by UnityPoint Health 10 months ago
Address Cedar Rapids, IA, United States
Hospice Registered Nurse Jobs
Recruited by Gentiva Hospice 10 months ago
Address Panora, IA, United States
Home Health Aide (Hha) - Hospice
Recruited by VNA Health 11 months ago
Address , Santa Ynez Valley, Ca
$22.50 - $25.50 an hour
Lpn Hospice Nurse Prn
Recruited by Amedisys, Inc. 11 months ago
Address , Knoxville, 37918, Tn
Medical Review Nurse (Snf Focus)
Recruited by Performant Financial Corporation 11 months ago
Address , Remote
Medical Review Nurse (Readmissions Focus)
Recruited by Performant Financial Corporation 11 months ago
Address , Remote
Home Health Registered Nurse $70 P/Hr
Recruited by Senior Management Services 11 months ago
Address , Renton, 98055, Wa
$70 an hour
Nurse Practitioner Hospice Prn
Recruited by Amedisys, Inc. 11 months ago
Address , Greenville, 29615, Sc
$125 an hour
Home Health Infusion Nurse - Litchfield County
Recruited by Option Care Health 11 months ago
Address , Shelton, Ct
$45.79 an hour
Home Health Aide - Hha
Recruited by Visiting Angels 11 months ago
Address , Montgomery, Al
Home Health & Hospice Surveyors (Contract Needed)
Recruited by Accreditation Commission for Health Care 11 months ago
Address , Remote
Certified Home Health Aide (Chha), Hospice (San Mateo County)
Recruited by ANX Home Healthcare & Hospice Care 1 year ago
Address , Daly City, Ca
$25 - $27 an hour
Home Health Visit Nurse - Marshalltown
Recruited by Iowa Home Care 1 year ago
Address , Marshalltown, 50158, Ia
Certified Home Health Aide (Chha), Home Health (San Mateo County Part-Time))
Recruited by ANX Home Healthcare & Hospice Care 1 year ago
Address , Daly City, Ca
Up to $72,800 a year
Registered Nurse (Home Health)
Recruited by US Veterans Health Administration 1 year ago
Address , Little Rock, 72205, Ar
$73,855 - $164,544 a year
Health Facilities Surveyor - Home Health & Hospice
Recruited by State of Iowa - Executive Branch 1 year ago
Address Iowa, IA, United States
Maternal Child Health Nurse
Recruited by Cass County Health Department 1 year ago
Address , Virginia, 62691, Il
Registered Nurse Home Health Care
Recruited by Southwest Florida Home Care, Inc. 1 year ago
Address , Tampa, 33624, Fl
Hospice Aide Jobs
Recruited by Compassus 1 year ago
Address , Monroe, La
$15.00 - $26.02 an hour
Home Health Central Intake Nurse (Rn) Partial Remote Position
Recruited by Lehigh Valley Health Network 1 year ago
Address , Allentown, 18103, Pa
Medical Review Specialist Iii (Medicare Durable Medical Equipment)
Recruited by Empower AI Inc. 1 year ago
Address , Remote
Registered Nurse Home Health
Recruited by Ascension at Home - Together with Compassus 1 year ago
Address , Vestavia, Al
$71,978 - $84,448 a year
Hospice Care Registered Nurse - Eastern Suffolk
Recruited by Northwell Health 1 year ago
Address , Woodbury, 11797, Ny
$73,000 - $117,000 a year
Medical, Legal, Regulatory Review Specialist
Recruited by Exact Sciences Corporation 1 year ago
Address , Remote
Nurse Medical Mgmt I (Contract)
Recruited by Elevance Health 1 year ago
Address , Remote
Medical Review Nurse (Home Health And Hospice)
Company | Performant Financial Corporation |
Address | , Remote |
Employment type | FULL_TIME |
Salary | |
Expires | 2023-09-10 |
Posted at | 9 months ago |
The Medical Review Nurse (Home Health and Hospice) performs medical claims audit reviews. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government, and Commercial Payers. You will work in a fast paced and dynamic environment and be part of a multi-location team.
In this role, you will be responsible for:
- Cross train in all clinical departments/areas
- Interface with and support the Medical Director
- Other duties as required to meet business needs
- Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse
- Assist with QA functions
- Keep abreast of medical practice, changes in technology, and regulatory issues that may affect the our clients
- Generating letters articulating audit findings
- Assist with training team members
- Auditing claims for medically appropriate services provided in both inpatient and outpatient settings
- Supporting your findings during the appeals process if requested
- Applying appropriate medical review guidelines, policies and rules
- Documenting all findings referencing the appropriate policies and rules
- Suggest ideas that may improve audit work flows
- Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits
- Work with the team to minimize the number of appeals
Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.
Required Skills and Knowledge:
- Excellent written and verbal communication skills.
- Not currently sanctioned or excluded from the Medicare program by the OIG.
- Experience with utilization management systems or clinical decision making tools such as Medical Coverage Guidelines (MCG) or InterQual.
- Active unrestricted RN, LPN or LVN license in good standing.
- Strong preference for experience performing utilization review for an insurance company, Tricare, MAC or organizations performing similar functions
- Ability to maintain high quality work while meeting strict deadlines.
- Experience with ICD-9, ICD-10, CPT-4 or HCPCS coding.
- Knowledge of insurance programs program, particularly the coverage and payment rules.
- Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
- Ability to manage multiple tasks including desk audits and claims review.
- Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings.
- Work independently and with team members effectively.
Additional Requirements:
Physical Requirements:
**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff may be notified and required to work from a Performant office location on an ad-hoc or periodic basis.
Basic office equipment required to perform remote work is provided by the company.
Education and Experience:
- Minimum of five (5) years (Registered Nurse) or eight (8) years (Licensed Practical Nurse/Licensed Vocational Nurse) of diversified nursing experience providing direct care in an inpatient or outpatient setting. RN license is preferred over LPN/LVN license for this role.
- One (1) or more years experience performing medical records review.
- One (1) or more years experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required. (Preferred for clinical, mandatory for coding).
Other Requirements:
Performant is a Government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and clearances (as applicable).
Applicants must have reliable, secure, high speed Internet access at their home office location.
Employment VISA Sponsorship is not available for this position
Job Profile is subject to change at any time.
EEO
Performant Financial Corporation is an Equal Opportunity Employer.
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER
-
Systems Analyst - Excel, Xml, Sql, Scripting
By CyberCoders At Salt Lake City, UT, United States 8 months ago
-
(Senior) Finance & Shared Services Manager
By Catholics For Choice At Washington, DC, United States 8 months ago
-
Paralegal - Probate Administration
By CyberCoders At Miami, FL, United States 8 months ago
-
Account Executive - Automotive Software
By ECW Search At United States 8 months ago
-
Construction Project Coordinator Jobs
By CyberCoders At River Falls, WI, United States 8 months ago