Job Details

ID #5094863
State Pennsylvania
City Harrisburg
Full-time
Salary USD TBD TBD
Source Anthem
Showed 2020-10-21
Date 2020-10-08
Deadline 2020-12-07
Category Et cetera
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Clinical Review Nurse I Medicare Part B - Fee for Service (REMOTE)

Pennsylvania, Harrisburg 00000 Harrisburg USA

Vacancy expired!

Primary duties

may include, but are not limited to :

Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials.

Requires :

AS / BS in nursing; 1 year of clinical experience with an understanding of clinical experience; or any combination of education and experience, which would provide an equivalent background.

Current unrestricted RN license in state of residence required.

Ability to comprehend and interpret medical policy and criteria to clearly articulate health information.

Intermediate level proficiency using MS Word and Excel

Must reside within 1 hour commute of one of our offices in Harrisburg, PA; Syracuse, NY; Dennison, TX; or Indianapolis, IN.

Additional skills strongly preferred :

CMS (Centers Medicare Medicaid Services) experience.

Knowledge of Medicare Part B Fee for Service a plus.

MCS claims system experience a plus.

Experience working in a virtual team.

Vacancy expired!

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