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Clinical Services Specialist RN
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Job Description
- Req#: 26-001
Employer Industry: Medical Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely from home with flexible hours
- Supportive and collaborative work environment
- Engage in meaningful work that impacts patient care and compliance
- Competitive pay and benefits package
What to Expect (Job Responsibilities):
- Analyze patient records to assess the legitimacy and necessity of medical services in compliance with government policies
- Serve as a resource for non-clinical staff regarding clinical-related inquiries
- Write and submit review summaries within specified timeframes
- Refer cases that do not meet medical necessity criteria to peer clinical reviewers
- Prepare monthly reports and communicate effectively with internal and external clients
What is Required (Qualifications):
- Must be a licensed Registered Nurse in the state of Arkansas or hold a multistate license
- Minimum of three (3) years of clinical nursing experience
- Associate's degree in nursing is required; Bachelor's degree in nursing is desirable
- Strong oral and written communication skills
- Knowledge of ICD 9/ICD 10 coding and medical terminology
How to Stand Out (Preferred Qualifications):
- Experience in Quality Assurance, Utilization Review, or coding
- Familiarity with health information technology (HIT) and electronic health records (EHR)
- Demonstrated ability to work collaboratively and independently
- Strong organizational and project management skills
#MedicalServices #RemoteWork #ClinicalNursing #CareerOpportunity #QualityAssurance
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