What are the responsibilities and job description for the Nurse Reviewer - Full Time Remote - PA position at Healthcare Quality Strategies, Inc.?
NURSE REVIEWERS (RN)
NURSE REVIEWER - FULL TIME REMOTE WORK – PA
Healthcare Quality Strategies, Inc. (HQSI), founded in 1982, is a small, vibrant not-for-profit organization in New Jersey with URAC accreditation as an Independent Review Organization. We are currently searching for several Nurse Reviewers (RN) who will work full time remotely to support our team.
Primary duties include performing medical necessity and policy review for Medicare and Medicaid claims, hospital systems and commercial payers. Requirements include:
- Active RN licensure in good standing
- Must have internet connection, and private work space; HQSI will provide equipment needed to perform job duties
- Minimum of two years’ experience performing medical record review, audit for federal or state contracts
- Knowledge and experience of Medicare and Medicaid policy (Part A, Part B and DME) a plus
- Medical terminology (familiarity with DRG validation, ICD-10, CPT and HCPCS preferred)
- Current standards of medical practice
- Solid analytical, assessment and communication skills (verbal and written)
- Strong attention to detail
- Strong attention to deadlines
- Computer proficiency (Word and Excel)
- Ability to work independently
For immediate consideration, please apply via the HQSI Careers Page at www.hqsi.org > Careers > Apply for this Position
or Apply via Indeed
EOE: Minorities/Females/Disabled/Veterans
Healthcare Quality Strategies, Inc. is an Equal Opportunity, Affirmative Action Employer and an Alcohol/Drug-Free Workplace
Healthcare Quality Strategies is an E-Verify employer
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