Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Salary up to $85,724.33
- Opportunity for career advancement and growth within the organization
- Work remotely with a flexible schedule
- Comprehensive benefits package including health, dental, and vision insurance
- Positive and collaborative work environment
- Incentive plan for additional compensation

What to Expect (Job Responsibilities):
- Review, research, and analyze medical records for compliance with regulations and standards of care
- Make accurate coverage and payment decisions based on evaluation standards
- Communicate decisions and provide education to stakeholders
- Identify potential fraud, waste, and abuse using established protocols
- Collaborate with peers and leaders for quality and calibration reviews

What is Required (Qualifications):
- Current, active, unrestricted RN license in state of practice
- 2 years of clinical experience
- 1 year of Microsoft Office experience
- Strong verbal and written communication skills
- Strong computer skills

How to Stand Out (Preferred Qualifications):
- Bachelor's degree in Nursing
- Experience evaluating medical records for compliance
- Experience in utilization review or case management
- Strong attention to detail and organizational skills
- Knowledge of coding

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