Talent.com
Utility Management Nurses (Insurance Coding & Revenue Management)
Utility Management Nurses (Insurance Coding & Revenue Management)Mercor • Binghamton, New York, US
Utility Management Nurses (Insurance Coding & Revenue Management)

Utility Management Nurses (Insurance Coding & Revenue Management)

Mercor • Binghamton, New York, US
21 hours ago
Job type
  • Part-time
  • Remote
Job description

###

  • Role Overview

We’re seeking experienced

  • Utility 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
    • Create a job alert for this search

    Utility • Binghamton, New York, US

    Related jobs
    Travel Nurse RN - Med Surg / Telemetry

    Travel Nurse RN - Med Surg / Telemetry

    ND Global Consulting Services • Binghamton, NY, US
    Full-time
    ND Global Consulting Services is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Binghamton, New York. Job Description & Requirements.Every other weekend Required Cert...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $3,205 per week

    Travel Nurse RN - Telemetry - $3,205 per week

    TRS Healthcare • Johnson City, NY, USA
    Full-time
    TRS Healthcare is seeking a travel nurse RN Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. TRS Healthcare Job ID #1283307.Pay package is based on 12 hou...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $2,679 per week

    Travel Nurse RN - Telemetry - $2,679 per week

    GHR Healthcare - Travel Division • Johnson City, NY, USA
    Full-time
    GHR Healthcare - Travel Division is seeking a travel nurse RN Telemetry for a travel nursing job in Johnson City, New York. Job Description & Requirements.OT Paid after 36 Hours • Health insurance ...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - ICU - Intensive Care Unit - $2,678 per week

    Travel Nurse RN - ICU - Intensive Care Unit - $2,678 per week

    First Connect Health • Johnson City, NY, United States
    Full-time
    First Connect Health is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Johnson City, New York. Job Description & Requirements.Nights; 36 / week, every other weekend - ...Show more
    Last updated: 20 hours ago • Promoted • New!
    Travel Nurse RN - Med Surg / Telemetry - $2,561 per week

    Travel Nurse RN - Med Surg / Telemetry - $2,561 per week

    Voca Healthcare • Johnson City, NY, United States
    Full-time
    Voca Healthcare is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. Shift : 3x12 hr Nights 36 / week, every other weeken...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry PCU - Progressive Care Unit

    Travel Nurse RN - Telemetry PCU - Progressive Care Unit

    Nationwide Therapy Group • Johnson City, NY, US
    Full-time
    Nationwide Therapy Group is seeking a travel nurse RN Telemetry PCU - Progressive Care Unit for a travel nursing job in Johnson City, New York. Job Description & Requirements.Telemetry PCU - Pro...Show more
    Last updated: 22 hours ago • Promoted • New!
    Travel Nurse RN - Telemetry - $2,122 per week

    Travel Nurse RN - Telemetry - $2,122 per week

    TNAA TotalMed RN • Johnson City, NY, United States
    Permanent
    TNAA TotalMed RN is seeking a travel nurse RN Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. We are seeking a Registered Nurse-Telemetry for a travel as...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $3,159 per week

    Travel Nurse RN - Telemetry - $3,159 per week

    Uniti Med • Johnson City, NY, USA
    Full-time
    Uniti Med is seeking a travel nurse RN Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. Pay package is based on 12 hour shifts and 48 hours per week (subj...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Med Surg

    Travel Nurse RN - Med Surg

    Halcyon Nurse Staffing • Vestal, NY, US
    Permanent
    Halcyon Nurse Staffing is seeking a travel nurse RN Med Surg for a travel nursing job in Vestal, New York.Job Description & Requirements. Halcyon Nurse Staffing Job ID #7.Pay package is based on...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Med Surg / Telemetry - $2,525 per week

    Travel Nurse RN - Med Surg / Telemetry - $2,525 per week

    Voca Healthcare • Johnson City, NY, United States
    Full-time
    Voca Healthcare is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. Shift : 3x12 hr Nights 36 / week, every other weeken...Show more
    Last updated: 7 days ago • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Trustaff • Johnson City, NY, US
    Full-time
    Trustaff is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Johnson City, New York.Job Description & Requirements. As a Stepdown RN, you'll monitor patients...Show more
    Last updated: 17 days ago • Promoted
    Travel Nurse RN - Telemetry - $2,544 per week

    Travel Nurse RN - Telemetry - $2,544 per week

    Host Healthcare • Johnson City, NY, United States
    Full-time
    Host Healthcare is seeking a travel nurse RN Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. Host Healthcare Job ID #a1fVJ000007z81SYAQ.Pay package is ba...Show more
    Last updated: 2 days ago • Promoted
    Travel Nurse RN - Telemetry - $2,651 per week

    Travel Nurse RN - Telemetry - $2,651 per week

    ALOIS Healthcare • Johnson City, NY, United States
    Full-time
    ALOIS Healthcare is seeking a travel nurse RN Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. A telemetry RN has several job responsibilities including : ...Show more
    Last updated: 22 days ago • Promoted
    Travel Nurse RN - Telemetry PCU - Progressive Care Unit - $2,678 per week

    Travel Nurse RN - Telemetry PCU - Progressive Care Unit - $2,678 per week

    First Connect Health • Johnson City, NY, United States
    Full-time
    First Connect Health is seeking a travel nurse RN Telemetry PCU - Progressive Care Unit for a travel nursing job in Johnson City, New York. Job Description & Requirements.Telemetry PCU - Progressive...Show more
    Last updated: 2 days ago • Promoted
    Travel Nurse RN - Float Telemetry - $3,360 per week

    Travel Nurse RN - Float Telemetry - $3,360 per week

    GHR Healthcare • Johnson City, NY, USA
    Full-time
    GHR Healthcare is seeking a travel nurse RN Float Telemetry for a travel nursing job in Johnson City, New York.Job Description & Requirements. GHR Healthcare Job ID #67004894.Pay package is based on...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $2,590 per week

    Travel Nurse RN - Telemetry - $2,590 per week

    Sunbelt Staffing • Binghamton, NY, United States
    Full-time
    Sunbelt Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Binghamton, New York.Job Description & Requirements. What you do is so much more than a job.It’s your way to sprea...Show more
    Last updated: 1 day ago • Promoted
    Travel Nurse RN - Telemetry PCU - Progressive Care Unit

    Travel Nurse RN - Telemetry PCU - Progressive Care Unit

    ProMed Staffing Resources A • Johnson City, NY, US
    Full-time
    ProMed Staffing Resources A is seeking a travel nurse RN Telemetry PCU - Progressive Care Unit for a travel nursing job in Johnson City, New York. Job Description & Requirements.Telemetry PCU - ...Show more
    Last updated: 22 hours ago • Promoted • New!
    Travel Nurse RN - Telemetry - $1,966 to $2,495 per week in Johnson City, NY

    Travel Nurse RN - Telemetry - $1,966 to $2,495 per week in Johnson City, NY

    TravelNurseSource • Johnson City, NY, US
    Full-time
    TravelNurseSource is working with Envista Resources to find a qualified Telemetry RN in Johnson City, New York, 13790!.With Envista Healthcare Staffing, your healthcare career is an open ticket to ...Show more
    Last updated: 15 days ago • Promoted