Vacancy expired!
NGS Clinical Review Nurse I (PS20265)Location: United StatesNewField: MedicalRequisition #: PS20265Your Talent. Our Vision. At National Government Services (NGS) , an independent subsidiary of
Anthem, Inc. and one of the largest Medicare contractors in the country,it’s a powerful combination. It’s the foundation upon which we’re creating
greater access to care for our members, greater value for our customers and
greater health for our communities. Join us and together we will drive thefuture of health care .This is an exceptional opportunity
to do innovative work that means more to you and those we serve.NGS Clinical Review Nurse I (PS20265)Work location – NGS Office Locations: Indianapolis IN,S outh PortlandME, Denison TX, Syracuse NY, Harrisburg PAResponsible for reviewing and making medical determinations
as to whether a claim meets the benefits the member carries. Primary duties may
include, but are not limited to:
Assesses the necessity andreasonableness of the items supplied in a valid claim through the use ofmedical policy and other materials.
Outpatientor surgical experience helpful.
Experiencewith MCS or other CMS mainframe system helpful.
Priorexperience with claim review helpful.
Workfrom home only for internal candidates who are already in a WAHposition.Otherwise must workin NGS office.
Requires an AS/BS
in nursing; 1 year of clinical experiencewith an understanding of clinical;or any combination of education and experience, which would
provide an equivalent background. Current unrestricted RN license required.
Ability to comprehend medical policy and criteria to clearly articulate health
information required.Anthem, Inc. is ranked asone of America’s Most Admired Companies among health insurers by Fortunemagazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. Tolearn more about our company and apply, please visit us atcareers.antheminc.com. An EqualOpportunity Employer/Disability/Veteran.
Vacancy expired!