RN - Claims Review Management Nurse (13298)
Claims Review Mgmt | Harrisburg, PA | Contract
Work Location: Harrisburg, PA
InGenesis is currently seeking a Claims Review Management Nurse to work with our client located in Harrisburg, PA. In this role, you will consult with senior staff to outline major operational issues and develop resolutions based on sound data analysis.
If you meet the qualifications outlined below, apply now and we’ll reach out to answer any questions you may have!
• Evaluate and implement system enhancements for provider enrollment, provider inquiry, and medical review.
• Evaluate current processes and implement recommended process improvements.
• Assist in determining if any changes should be made to criteria or regulations to better serve clients.
• Review certain claims, analyze, and process through the payment system.
• Provide operational input for claims processing decisions.
• Assist with coding and procedure code groupings.
• Participate in yearly coding updates.
• Assist in updating the system according to reviewed and accepted codes.
• Work at one or more of the department's work sites, as requested.
• Perform other duties as assigned.
• Current Registered Nurse / RN license in the state of Pennsylvania.
• 5+ years of experience with claims review, coding, or processing.
• Knowledge of utilization review processes.
• Basic computer skills.
• Proficiency in Excel.
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.
InGenesis is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at https://www.ingenesis.com/careers/site-accommodations.