Remote RN Medical Reviewer - Part-Time, $40/hr

HQSI; Tampa (FL); Remote; USD 45,460 - 64,747; Part time

Benefits offered by this job

Medical/Dental/Vision

401k

Flexible Spending Account (FSA)

Health Savings Account (HSA)

Job summary

A healthcare quality organization is seeking a Nurse Reviewer to support Medical Review Services. The role involves conducting detailed medical necessity reviews for Medicaid claims in a remote work setting. Candidates should have a BSN with active RN licensure and at least three to five years' experience in medical record review. This position offers a competitive hourly rate with various employee benefits, including medical and dental plans.

Qualifications

• At least three to five years of experience in medical record review/abstraction.
• Experience auditing for federal or state contracts.
• Current familiarity with clinical screening criteria (InterQual and MCG).

Responsibilities

• Conduct comprehensive medical record reviews for Medicaid claims.
• Manage case screening processes to meet deadlines.
• Document evidence-based criteria for contracts.

Skills

Medical terminology

ICD-10

CPT

Proficiency with Microsoft Office

Strong attention to detail

Effective communication

Education

BSN with active RN licensure

Tools

Adobe PDF

Job description

A healthcare quality organization is seeking a Nurse Reviewer to support Medical Review Services. The role involves conducting detailed medical necessity reviews for Medicaid claims in a remote work setting. Candidates should have a BSN with active RN licensure and at least three to five years' experience in medical record review. This position offers a competitive hourly rate with various employee benefits, including medical and dental plans.