To ensure compliance with healthcare guidelines, the full-time Remote Registered Nurse Claims Analyst will perform medical record and claims reviews for Medicare, Medicaid, and other claims data, assessing for potential overpayment, fraud, waste, and abuse. Key responsibilities Facilitates and manages assigned projects and contracts related to pharmacy services, ensuring contract specifications are met Reviews and interprets contract deliverables for timely and accurate completion while contributing to project design and execution Provides educational programs and professional presentations to meet project goals and supports changes in care practices Required qualifications 5-7 years of work experience in clinical and utilization review or case management; 8-11 years preferred Current, active RN license issued by the state board of nursing BSN degree strongly preferred; candidates with an ADN will be considered with equivalent experience Coding certification preferred Strong analytical skills with the ability to make sound, timely decisions
Registered Nurse Claims Analyst in workfromhome at Unknown Company
- Typical pay
- $71,760–$109,200
For context, most registered nurses earn between $71,760–$109,200 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as contract and able to be worked remotely.