RN Medical Reviewer

Job Summary

A company is looking for a Medical Claims Reviewer for a 6-month contract position.

Key Responsibilities

• Conduct ESRD medical record reviews comparing documentation to EQRS and NHSN for accuracy
• Determine and classify discrepancies based on type and severity of errors
• Participate in quality control activities and assist with special projects as assigned

Minimum Qualifications

• Active, unrestricted RN licensure in the United States or compact multistate RN license
• Associate Degree in Nursing or graduate of an accredited School of Nursing
• Two years of clinical experience plus two years of experience in utilization/medical review or quality assurance
• Strong clinical background in dialysis, managed care, or medical-surgical settings
• Proficiency with word processing software and Microsoft Office