RN Medical Reviewer

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