Apply

Remote RN

Posted about 13 hours agoViewed

View full description

šŸ’Ž Seniority level: Junior, 2-3 years

šŸ“ Location: Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Louisiana, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, PST

šŸ’ø Salary: 45.0 - 55.0 USD per hour

šŸ” Industry: Healthcare

šŸ—£ļø Languages: English

ā³ Experience: 2-3 years

šŸŖ„ Skills: Communication SkillsAnalytical SkillsComplianceQuality AssuranceRisk Management

Requirements:
  • Clinical expertise in Health care, Clinical documentation, and Medical records management.
  • Experience in OBGYN, Pediatrics, and Inpatient Psychiatry.
  • Minimum 2-3 years of Clinical Documentation Specialist experience.
  • IMG with a medical degree or RN license.
  • CCDS or CCDIP required.
  • Experience with quality-based reviews, mortality reviews, and risk adjustment tools.
  • Preferred specialties in OBGYN, Pediatrics, and Inpatient Psychiatry.
Responsibilities:
  • Conduct concurrent medical record reviews to ensure accurate and complete documentation.
  • Collaborate with physicians and healthcare professionals to clarify and improve documentation.
  • Ensure documentation reflects the severity of illness and quality of care provided.
  • Adhere to MS-DRG classification and compliance regulations.
  • Perform quality-based reviews, mortality reviews, and utilize risk adjustment tools.
Apply

Related Jobs

Apply
šŸ”„ Remote RN
Posted 1 day ago

šŸ“ Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Louisiana, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington

šŸ§­ Temporary

šŸ’ø 45.0 - 55.0 USD per hour

šŸ” Healthcare

  • Clinical expertise in Health care, Clinical documentation, and Medical records management.
  • Experience in OBGYN, Pediatrics, and Inpatient Psychiatry.
  • Minimum 2-3 years of Clinical Documentation Specialist experience.
  • IMG with a medical degree or RN license.
  • CCDS or CCDIP required.
  • Experience with quality-based reviews, mortality reviews, and risk adjustment tools.
  • Conduct concurrent medical record reviews to ensure accurate and complete documentation.
  • Collaborate with physicians and healthcare professionals to clarify and improve documentation.
  • Ensure documentation reflects the severity of illness and quality of care provided.
  • Adhere to MS-DRG classification and compliance regulations.
  • Perform quality-based reviews, mortality reviews, and utilize risk adjustment tools.

SQLData AnalysisAnalytical SkillsCollaborationAttention to detailWritten communicationComplianceInterpersonal skillsVerbal communicationQuality AssuranceRisk Management

Posted 1 day ago
Apply
Apply
šŸ”„ Remote RN
Posted 1 day ago

šŸ“ Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Louisiana, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington

šŸ§­ Temporary

šŸ’ø 45.0 - 55.0 USD per hour

šŸ” Healthcare

  • Clinical expertise in Health care, Clinical documentation, and Medical records management.
  • Experience in OBGYN, Pediatrics, and Inpatient Psychiatry.
  • Minimum 2-3 years of Clinical Documentation Specialist experience.
  • Licensure/Education: IMG with a medical degree or RN license.
  • Certifications: CCDS or CCDIP required.
  • Experience with quality-based reviews, mortality reviews, and risk adjustment tools.
  • Conduct concurrent medical record reviews to ensure accurate and complete documentation.
  • Collaborate with physicians and healthcare professionals to clarify and improve documentation.
  • Ensure documentation reflects the severity of illness and quality of care provided.
  • Adhere to MS-DRG classification and compliance regulations.
  • Perform quality-based reviews, mortality reviews, and utilize risk adjustment tools.

Data AnalysisCommunication SkillsAnalytical SkillsCollaborationProblem SolvingAttention to detailOrganizational skillsWritten communicationComplianceInterpersonal skillsCritical thinkingTeamworkActive listeningQuality AssuranceRisk Management

Posted 1 day ago
Apply
Apply

šŸ“ United States

šŸ§­ Full-Time

  • Active, unrestricted RN license in the U.S. and in the state of hire OR Active compact multistate RN license (as defined by the Nurse Licensure Compact).
  • Associate Degree in Nursing OR Graduate of an accredited School of Nursing.
  • Two years of clinical experience plus at least two years in one of the following: Home Health, Utilization/Medical Review, Quality Assurance
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.

Communication SkillsAnalytical SkillsCustomer serviceMicrosoft OfficeComplianceCritical thinkingQuality Assurance

Posted 2 days ago
Apply
Apply
šŸ”„ Remote RN
Posted 7 days ago

šŸ“ Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Louisiana, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington

šŸ§­ Temporary

šŸ’ø 45.0 - 55.0 USD per hour

šŸ” Health care

  • Clinical expertise in Health care, Clinical documentation, and Medical records management.
  • Experience in OBGYN, Pediatrics, and Inpatient Psychiatry.
  • Minimum 2-3 years of Clinical Documentation Specialist experience.
  • Licensure/Education: IMG with a medical degree or RN license.
  • Certifications: CCDS or CCDIP required.
  • Experience with quality-based reviews, mortality reviews, and risk adjustment tools.
  • Preferred specialties in OBGYN, Pediatrics, and Inpatient Psychiatry.
  • Conduct concurrent medical record reviews to ensure accurate and complete documentation.
  • Collaborate with physicians and healthcare professionals to clarify and improve documentation.
  • Ensure documentation reflects the severity of illness and quality of care provided.
  • Adhere to MS-DRG classification and compliance regulations.
  • Perform quality-based reviews, mortality reviews, and utilize risk adjustment tools.

SQLComplianceQuality AssuranceRisk ManagementData analytics

Posted 7 days ago
Apply
Apply

šŸ“ United States

šŸ§­ Contract

šŸ’ø 25 - 25 USD per hour

šŸ” Insurance

šŸ¢ Company: CortexšŸ‘„ 251-500šŸ’° $48,166,880 Series C over 2 years agoCustomer ServiceArtificial Intelligence (AI)Big DataAnalyticsInformation TechnologySoftware

  • Current and active US RN license.
  • Reside within the United States.
  • Willingness to accept a temporary contract in the event of a hurricane or natural disaster.
  • Availability to complete an 8-hour training course and commence work within 72 hours of activation.
  • Excellent communication skills to interact with policyholders with empathy and professionalism.
  • Quick learner with the ability to adapt to new platforms and technologies rapidly.
  • Computer savvy, capable of navigating new systems efficiently.
  • Receive and manage inbound phone calls from policyholders affected by hurricanes.
  • Gather accurate and detailed information about insurance claims.
  • Provide clear and concise guidance on claim submission procedures.
  • Demonstrate empathy and professionalism while assisting individuals during challenging times.
  • Collaborate with team members to ensure efficient call handling and issue resolution.

Communication SkillsProblem SolvingAdaptabilityEmpathyComputer skills

Posted 5 months ago
Apply