A company is looking for a Nurse Educator / Review Coordinator.
Key Responsibilities
Facilitate provider education related to claim reviews and Medicare policies
Collaborate with management to identify billing issues and improve provider compliance
Conduct desktop medical reviews and support physician reviewers with case summaries
Required Qualifications
Graduation from an accredited school of nursing and current RN licensure or equivalent qualifications
Experience in Medicare QIO claim reviews or medical reviews for MAC or RAC appeals
Knowledge of ICD-10-CM / PCS coding rules and DRG assignment
Clinical background in healthcare-related fields preferred
Ability to maintain confidentiality in compliance with HIPAA and HITECH regulations
Nevada Licensed Nurse Educator • Ontario, California, United States
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