Healthcare Claims Examiner, RN Required
General Dynamics Information Technology
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
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Salary
💰 $60,350 - $81,650 per year
About the role
- Evaluate appropriateness of beneficiaries' admission to nursing facilities
- Verify documentation of medical necessity for prior approval requests
- Meet performance expectations by completing at least 40 prior approval reviews daily
- Achieve quality assurance reviews with greater than 95% accuracy
- Complete timely reviews within 24 hours
Requirements
- Active North Carolina Registered Nurse license or Compact license
- At least 2 years of clinical experience
- Knowledge of Microsoft Office and Outlook
- Experience with medical documentation review
- Knowledge of NCTracks and business processes of North Carolina Division of Medicaid preferred
- Clinical medical, surgical and nursing facility experience preferred
- Clinical research experience preferred
Benefits
- Variety of medical plan options
- 401(k) plan with company match
- Full flex work weeks where possible
- Paid time off including vacation, sick and personal time, and holidays
- Paid parental, military, bereavement and jury duty leave
- 15 days of paid leave per calendar year
- 10 paid holidays per year
- Paid Family Leave program
- Short and long-term disability benefits
- Life and accidental death and dismemberment insurance
- Critical illness and travel accident insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical documentation reviewclinical experiencequality assuranceprior approval reviewsclinical research
Soft Skills
attention to detailtime managementperformance expectations
Certifications
North Carolina Registered Nurse licenseCompact license