Job Posting for Nurse Reviewer - Per Diem - Remote PA -Scranton at Healthcare Quality Strategies, Inc.

NURSE REVIEWERS (RN)

REMOTE WORK

PER DIEM: Non-Exempt - FLEXIBLE 20-30 HOURS PER WEEK

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 remotely to supplement our team.

Primary duties include performing medical necessity and policy review for Medicaid claims, hospital systems and commercial payers; RN will work closely with Physician Peer Reviewer and contract team.

Requirements include:

Active RN licensure in good standing
Must have own computer equipment (preferably desktop), internet connection, and private work space
Experience performing medical record review, audit for federal or state contracts
Knowledge and experience of Medicare and Medicaid policy
Medical terminology; (familiarity with 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
Flexible schedule with need for availability to attend periodic scheduled touchpoints during normal business hours

Primary duties include performing medical necessity and policy review for Medicaid claims, hospital systems and commercial payers; RN will work closely with Physician Peer Reviewer and contract team.

Requirements include:

Active RN licensure in good standing
Must have own computer equipment (preferably desktop), internet connection, and private work space
Experience performing medical record review, audit for federal or state contracts
Knowledge and experience of Medicare and Medicaid policy
Medical terminology; (familiarity with 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
Flexible schedule with need for availability to attend periodic scheduled touchpoints during normal business hours

Physical Demands:

The conditions herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

Primary functions require sufficient physical ability and mobility to work in an office setting;

to sit for prolonged periods of time; to occasionally stand, stoop, bend, kneel, crouch, reach, and twist; to operate office equipment requiring repetitive hand movement and fine coordination including use of a computer keyboard and to verbally communicate to exchange information.

Candidates must be based in PA.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Healthcare Quality Strategies, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

For immediate consideration, please submit resume and cover letter to: careers@hqsi.org

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

EOE: Minorities/Females/Disabled/Veterans

Apply for this job

Receive alerts for other Nurse Reviewer - Per Diem - Remote PA -Scranton job openings

Hourly Wage Estimation for Nurse Reviewer - Per Diem - Remote PA -Scranton in Scranton, PA

$35.81 - $46.07

For Employer

Looking to price a job for your company?

Price This Job

Nurse Reviewer - Per Diem - Remote PA -Scranton

Job Posting for Nurse Reviewer - Per Diem - Remote PA -Scranton at Healthcare Quality Strategies, Inc.

Sign up to receive alerts about other jobs that are on the Nurse Reviewer - Per Diem - Remote PA -Scranton career path.

Sign up to receive alerts about other jobs with skills like those required for the Nurse Reviewer - Per Diem - Remote PA -Scranton.

Not the job you're looking for? Here are some other Nurse Reviewer - Per Diem - Remote PA -Scranton jobs in the Scranton, PA area that may be a better fit.

We don't have any other Nurse Reviewer - Per Diem - Remote PA -Scranton jobs in the Scranton, PA area right now.