Utility Management Nurses (Insurance Coding & Revenue Management)Mercor • Temecula, California, US
No longer accepting applications
Utility Management Nurses (Insurance Coding & Revenue Management)
Mercor • Temecula, California, US
1 day ago
Job type
- Part-time
- Remote
Job descriptionUtility Management Nurses to support a client’s healthcare product development by leveraging expertise in insurance coding and hospital revenue management workflows . This role involves collaborating with hospital systems to align medical documentation with insurance policies, ensuring accurate coding and optimal reimbursement outcomes. ### Key Responsibilities Insurance Coding & Revenue Cycle Alignment : Review, audit, and optimize insurance coding practices across hospital systems to ensure compliance and maximize reimbursement accuracy. - Workflow Analysis : Evaluate existing revenue management workflows and recommend improvements tailored to client’s AI-driven documentation tools. - Clinical Data Interpretation : Translate complex clinical notes into standardized coding formats (ICD-10, CPT, HCPCS) aligned with payer policies. - Policy Matching : Assess coding accuracy against insurance guidelines and payer documentation requirements. - Product Development Collaboration : Work closely with client’s engineering and product teams to refine AI models that automate or assist with medical coding and documentation. - Compliance & Quality Assurance : Ensure alignment with HIPAA, CMS, and payer-specific coding regulations. ### Required Qualifications Licensure : Registered Nurse (RN) or equivalent clinical background. - Experience : Minimum 3–5 years in medical coding clinical documentation improvement (CDI) , or revenue cycle management . - Certifications : CPC, CCS, or CRC certification preferred. - Domain Expertise : Familiarity with hospital billing systems payer policy interpretation , and coding audit procedures . - Analytical Skills : Strong understanding of clinical documentation standards and payer logic. - Tech Savvy : Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software. ### Preferred Qualifications Experience working within hospital revenue integrity teams or insurance utilization management . - Exposure to AI-powered healthcare documentation tools or automated coding systems . - Ability to identify and flag edge cases or policy exceptions in automated workflows. - Strong collaboration skills with cross-functional (engineering, compliance, and data) teams. ### Engagement Model Contract / Part-time (Remote / In person) — Flexible hours with collaboration during U.S. business hours. In person in San Francisco is a plus
###
- Role Overview
We’re seeking experienced
Create a job alert for this search
Utility • Temecula, California, US
Related jobs
Join the Southwest Healthcare Team!.Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care / outpatient locations here to se...Show more
Join the Southwest Healthcare Team!.Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care / outpatient locations here to se...Show more
Stability Healthcare is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Escondido, California.
Job Description & Requirements.Day 1 health insurance with United Healt...Show more
MedPro Healthcare Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Escondido, California.
Job Description & Requirements.Joint Commission-certified staffing agenc...Show more
FlexCare is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift : 5x8 hr days Start Date : ASAP Duration : 13 weeks Pay : $3368.Why Clinicians...Show more
Stability Healthcare is seeking a travel nurse RN Telemetry Med Surg for a travel nursing job in Poway, California.Job Description & Requirements.
Stability Healthcare is looking for a Telemetry RN ...Show more
Skills required : ICP monitoring, PA Catheters, Procedural Sedation.Current CA RN License required at time of submittal.Drivers License or ID with address required.Show more
TNAA TotalMed Case Management is seeking a travel nurse RN Home Health for a travel nursing job in San Marcos, California.
Job Description & Requirements.We are seeking a Home Health-Registered Nurs...Show more
Sign up on our platform reshaping healthcare staffing! With our intuitive platform, you'll experience flexible scheduling and personalized rates.
Why sign up? Take charge of your schedule today and ...Show more
PRN Healthcare is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Escondido, California.Job Description & Requirements.
PRN Healthcare Job ID #1348708.Pay package is based o...Show more
Founded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting.TOI is dedicated to off...Show more Join the Southwest Healthcare Team!.Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care / outpatient locations here to se...Show more 
Anders Group is seeking a travel nurse RN Med Surg for a travel nursing job in San Marcos, Texas.Job Description & Requirements.
Pay package is based on 12 hour shifts and 36 hours per week (subject...Show more
The Wound Management Nurse works collaboratively with physicians and staff to provide consultation regarding the clinical care of patients with wounds, ostomies and other specials skin care needs.U...Show more
Cross Country Nurses is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in San Marcos, California.
Job Description & Requirements.As a medical / surgical telemetry nurse (RN M / ...Show more
Access Healthcare is seeking a travel nurse RN Med Surg Level I for a travel nursing job in San Marcos, Texas.Job Description & Requirements.
Pay package is based on 12 hour shifts and 36 hours per ...Show more
WHEN YOU WORK FOR US, WE WORK FOR YOU.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country.
You also get unmatched service.From the moment you...Show more
Salary range includes incentives that are contingent upon skills, competencies, longevity, experience and geographic location.
The earnings included in the salary range are contingent upon requisite...Show more
Utilization Review Nurse - Per Diem
Universal Health Services, Inc. • Temecula, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
LVN Central Utilization Review Nurse - Per Diem
UHS • Temecula, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
Travel Nurse RN - ICU - Intensive Care Unit - COVID19 - $2,471 per week
Stability Healthcare • Escondido, CA, USA
Full-time
Last updated: 30+ days ago • Promoted
Travel Nurse RN - Labor and Delivery - $2,764 per week
MedPro Healthcare Staffing • Escondido, CA, USA
Full-time
Last updated: 30+ days ago • Promoted
Travel Nurse - RN - Case Manager - $3368.2 / Week - Hiring Now
FlexCare • San Marcos, CA, United States
Full-time
Last updated: 17 hours ago • Promoted • New!
Travel Medical-Surgical Telemetry RN - $2,365 per week
Stability Healthcare • Poway, CA, United States
Full-time
Last updated: 2 days ago • Promoted
Travel Nurse RN - ICU - Intensive Care Unit - COVID19 - $2,471 per week
Palomar Medical Center • Escondido, CA, USA
Full-time
Last updated: 30+ days ago • Promoted
Travel Nurse RN - Home Health - $2,473 per week
TNAA TotalMed Case Management • San Marcos, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
LVN|Vocational Nurse
Vitawerks • San Jacinto, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
Travel Nurse RN - Labor and Delivery - $2,757 per week
PRN Healthcare • Escondido, CA, USA
Full-time
Last updated: 30+ days ago • Promoted
Float Registered Nurse Outpatient Oncology Sign On 5k
The Oncology Institute of Hope and Innovation • Hemet, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
Utilization Review Nurse - Full-Time
Universal Health Services, Inc. • Temecula, CA, United States
Full-time
Last updated: 22 days ago • Promoted
Travel Telemetry Registered Nurse - $1,641 per week
Anders Group • San Marcos, CA, United States
Full-time
Last updated: 1 day ago • Promoted
Wound Mgmt RN - Acute Care / Full-time Days
KPC Health • Hemet, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
Travel Nurse RN - Med Surg / Telemetry - $2,405 per week
Cross Country Nurses • San Marcos, CA, United States
Full-time
Last updated: 3 days ago • Promoted
Travel Telemetry Registered Nurse - $1,840 per week
Access Health Care Physicians LLC • San Marcos, CA, United States
Full-time
Last updated: 1 day ago • Promoted
Travel Nurse RN - ER
Titan Medical Group • Nuevo, CA, United States
Full-time
Last updated: 30+ days ago • Promoted
Internal Medicine (Outpatient) – Full Time Opportunity
Kaiser Permanente – Southern California Permanente Medical Group • Temecula, US
Full-time +1
Last updated: 30+ days ago • Promoted