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Clinical Services Specialist RN
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Job Description
- Req#: 25-179
Employer Industry: Medical Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely from the comfort of your home
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and service delivery
- Competitive salary and benefits package
What to Expect (Job Responsibilities):
- Analyze patient records to determine the legitimacy and necessity of medical services in compliance with government reimbursement policies
- Serve as a resource for non-clinical staff by addressing clinical-related questions or issues
- Write accurate review summaries and submit them within the designated time frame
- Refer cases that do not meet medical necessity criteria to a peer clinical reviewer
- Communicate effectively with internal and external clients regarding utilization management requirements and procedures
What is Required (Qualifications):
- Diploma or Associate's degree in nursing, licensed as a Registered Nurse in the state of Arkansas
- Minimum of three (3) years of clinical nursing experience
- Strong oral and written communication skills
- Intermediate level computer skills (Excel, Word, Access, PowerPoint, and Outlook)
- Knowledge of ICD 9/ICD 10 coding and medical terminology
How to Stand Out (Preferred Qualifications):
- Bachelor's degree in nursing
- Experience in Quality Assurance / Utilization Review and/or coding
- Knowledge of health information technology (HIT) and electronic health records (EHR)
#MedicalServices #Nursing #RemoteWork #CareerOpportunity #PatientCare
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