Electrical Assembler 2

Point Eight Power; Village of Patchogue (NY); Hybrid; USD 62,000 - 66,000; Full time

Job summary

An established industry player is seeking a skilled nursing professional to join their team in a pivotal role focused on healthcare claims. This position offers the chance to leverage your clinical experience and nursing knowledge to ensure accurate billing and improve healthcare outcomes. With a potential for remote work after 90 days, this role provides an opportunity to grow within a supportive environment. The generous benefits package includes medical, dental, and vision insurance, along with a 401K plan and tuition reimbursement. If you are detail-oriented and possess excellent communication skills, this could be the perfect fit for you.

Benefits

Medical Insurance

Dental Insurance

Life Insurance

Vision Insurance

Paid Vacation

Paid Holidays

Paid Sick Days

Short Term Disability

Long Term Disability

401K Plan With Company Match

Tuition Reimbursement

Employee Assistance Program

Qualifications

• Diploma in nursing required; RN or LPN preferred.
• 3+ years clinical hospital experience required.
• Active nursing license in the state of employment.

Responsibilities

• Screen claims by reviewing diagnosis, procedures, and patient information.
• Maintain effective communication with team members and customers.
• Generate production reports of screened claims.

Skills

Nursing Diploma

Active RN or LPN License

Clinical Hospital Experience

Healthcare Claim Audit Experience

Knowledge of Medical Necessity

CMS Claim Reimbursement Regulations

Experience with Payment Platforms

Coding Experience

Microsoft Word Proficiency

Microsoft Outlook Proficiency

Detail-oriented

Excellent Communication Skills

Typing Skills

Education

Associate Degree in Nursing

Bachelor’s Degree in Nursing

Tools

Facets

FEP

NASCO

Job description

Carewise Health helps organizations improve the personal health of employees and control healthcare costs. Our industry-leading health and wellness programs help members build the skills they need to achieve and sustain optimum health. Medical Bill Review ensures that health plans and self-insured employers are billed accurately for the care their members receive. Headquartered in Louisville, KY.

NOTE

Potential to be a remote position based on progression after the first 90 days.

Pay will be based on experience. Range from $62,000 to $66,000.

Responsibilities:

1. Screen referred claims by reviewing the diagnosis, procedures, length of stay, areas of charges, patient age, type of bill, state regulations, customer expectations, and historical information for the facility.
2. Route claims to appropriate product.
3. Meet prescreen deadlines.
4. Update facilities in the system as appropriate.
5. Develop a working rapport with customers by responding to inquiries in a timely manner with tact and understanding.
6. Maintain effective communication with team members.
7. Generate production reports of screen claims.
8. Other duties as assigned.

Benefits:

Carewise Health provides a generous benefits package including:

• Medical Insurance
• Dental Insurance
• Life Insurance
• Vision Insurance
• Paid Vacation
• Paid Holidays
• Paid Sick Days
• Short Term Disability
• Long Term Disability
• 401K Plan With Company Match
• Tuition Reimbursement
• Employee Assistance Program

All benefits are effective on the first day of employment with the exception of tuition reimbursement and STD/LTD, which is effective after 90 days of employment.

Attention Staffing Agencies: This position is not open for agency submittals. Any candidate submitted without HR approval will be considered an applicant of Carewise Health, not the agency. All Agency Candidates must first be submitted to HR.

EOE Disability/Veterans

Required Skills:

1. Diploma in nursing required (Associate or Bachelor’s degree in nursing preferred). Can be a RN or a LPN.
2. Must have an active & unrestricted registered nurse license in the state of employment or reciprocal state.
3. Minimum of three years clinical hospital experience.
4. Healthcare claim audit experience must be demonstrated.
5. Healthcare claim knowledge strongly suggested in the following areas: Medical Necessity, High Cost Specialty & NOC Infusions, High-cost Implants & Supplies, One Day Admissions, Readmissions, ER Visits, End Stage Renal Disease and HAC/Never Events.
6. Considerable knowledge of CMS claim reimbursement regulations a plus.
7. Experience with payment platforms Facets, FEP and NASCO a plus.
8. Coding experience a plus.
9. Must have excellent verbal and written communication skills.
10. Must be proficient in Microsoft Word and Microsoft Outlook.
11. Must be detail-oriented.
12. Must be able to work with deadlines.
13. Must have ability to organize and prioritize competing duties.
14. Proficient typing skills.
15. Must be able to successfully complete any required pre-employment testing.
16. Travel required for company, client or provider meetings.