Register Nurse

Job Description

Job Description

BCForward is currently looking Register Nurse in Phoenix, AZ  85034

Position Title : Register Nurse

Location : Phoenix, AZ  85034

Expected Duration : 3+ months.

Position Overview

The Medical Review Nurse (Claims Processor) will focus on the review and adjudication of Federal Emergency Services (FES) 1500 claim forms . The role requires evaluating medical necessity, accuracy of coding, and compliance with AHCCCS and federal guidelines. Coordination with medical providers may be needed for second-level reviews and verification of prior authorizations or UB claims.

Candidates with a current Arizona RN license and a Fingerprint Clearance Card will be prioritized, as the clearance can expedite the onboarding process. AHCCCS will provide remote desktop access setup once onboarded.

Key Responsibilities

• Review and adjudicate medical claims per industry and AHCCCS standards.
• Determine emergency criteria, medical necessity, and appropriate revenue code / CPT / HCPC coding.
• Evaluate level of care and length of stay for AHCCCS recipients.
• Analyze and prepare reports on savings, claim trends, and utilization outcomes.
• Collaborate with internal departments and external providers as needed.
• Conduct special assignments or research projects related to claims and utilization review.

Knowledge & Expertise

Skills & Abilities

Requirements

Preferred Qualifications

Benefits :

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale.  Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years.  Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum.  As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information.  BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment.  All applicants applying for positions in the United States must be legally authorized to work in the United States.  The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position.  Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Company Description

About BCforward :

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.

BCforward is an equal opportunity employer.

Company Description

About BCforward : \r\n\r\nFounded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.\r\n\r\nBCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.\r\n\r\nBCforward is an equal opportunity employer.