Workaholics4Hire.com

Location: Telecommuting : Work At Home
THIS POSITION HAS BEEN FILLED

Clinical Claim Review Supervisor – RN Required – Telecommuting Opportunity – Supervisory Exp a BIG Plus

Description

The Supervisor of Clinical Claims Review will attempt to rectify problems with claims or appeals, will escalate those cases that he/she is unable to resolve, and work hands-on with their staff.
Key responsibilities include:

* Reviewing system-generated denials and provider or customer appeals from their respective team
* Identifying issues involved in the disputes
* Forwarding unresolvable cases to Field Medical Directors
* Reporting on daily metrics
* Developing new process work flows
* Supervising a staff of 10+

**This individual must be within driving distance to a Group location to Work At Home. Any qualified candidate from around the United States is encouraged to apply, as long as there is a office nearby**
Regardless of your role, the support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So take the first step in what is sure to be a fast paced and highly diversified career.
Qualifications
Required Skills:

* ADN
* 5+ years of clinical experience
* Current and unrestricted RN license (in whichever state they reside in)
* Computer proficient – navigation through a computer and the Internet (Word, Internet, Outlook)
* Ability to work independently
* Coding and claims experience/knowledge
* Multi-tasking abilities
* Self-starter

Preferred Skills:

* BSN
* Utilization review experience
* Supervisory experience (performance management – can oversee daily workflow and assignments)
* Case management
* Chart review experience
* Milliman proficiency

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
[Company] is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Job Clinical Claims Review
Primary Location US-MD-Frederick
Other Locations US-MN-Plymouth, US-NC-Greensboro, US-MN-Duluth, US-NY-Kingston, US-MO-Springfield, US-FL-Oldsmar
Organization Inpatient Care Mgmt/Census
Schedule Full-time
Number of Openings 1

How To Apply For This Work At Home Job

THIS POSITION HAS BEEN FILLED