Molina Healthcare
Remote Medical Claim Review LVN - Work PST Hours
This job is now closed
Job Description
- Req#: 2024928
Employer Industry: Health Insurance
Why Consider this Job Opportunity:
- Possibility of Overtime and rotating weekend coverage
- Competitive benefits and compensation package
- Opportunity for career advancement and growth within the organization
- Chance to work with a leading health insurance company
- Supportive and collaborative work environment
- Opportunity to apply clinical expertise in medical claims review
What to Expect (Job Responsibilities):
- Administer claims payments and maintain claim records
- Provide counsel to claimants regarding coverage amount and benefit interpretation
- Monitor and control backlog and workflow of claims
- Ensure claims are settled in a timely fashion and in accordance with cost control standards
- Perform clinical/medical reviews of retrospective medical claim reviews
What is Required (Qualifications):
- Licensed Vocational Nurse / Licensed Practical Nurse
- Minimum three years clinical nursing experience
- Minimum one year Utilization Review and/or Medical Claims Review
- Active, unrestricted State Licensed Vocational Nurse (LVN) license in good standing
- Nursing experience in Critical Care, Emergency Medicine, Medical Surgical, or Pediatrics
How to Stand Out (Preferred Qualifications):
- Registered Nurse
- Bachelor's Degree in Nursing or Health Related Field
- Master's degree in Nursing or Health Related Field
- Billing and coding experience
- Certified Clinical Coder, Certified Medical Audit Specialists (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ) or other healthcare certification
#HealthInsurance #MedicalClaims #ClinicalExpertise #CareerGrowth #CompetitiveBenefits
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.
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