Travel Nurse RN - Case Manager - $2,566 per week in New York City, NY

TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in New York City, New York, 10004!

Pay Information

$2,566 per week

About The Position

Job Title : Chart Review Nurse

Profession : RN

Specialty : Clinical Review

Duration : 9 months

Shift : Hybrid (9 AM - 5 PM)

Hours per Shift : 40

Experience : Minimum 2 years

License : Client RN License

Certifications : Primary Source Verification

Must-Have : Clinical knowledge in reviewing medical charts

Description :

Use clinical knowledge to review medical charts for accuracy and sequencing of diagnoses.

Validate clinical and coding assessments based on consultation reports.

Assess history and physical reports, operative reports, progress reports, and discharge reports, including complex cases.

Review medical records and healthcare claims for accuracy and compliance with regulations, standards, policies, and procedures.

Conduct audits of high-risk claims and billing patterns to ensure adherence to healthcare regulations.

Collaborate with team members to evaluate suspected cases of fraudulent activities.

Create detailed reports with medical review findings, including research and recommendations.

Validate whether audited claims should be denied or recouped and determine required mitigation strategies.

Participate in provider calls to discuss findings and rationale of medical reviews.

Present findings to leadership and stakeholders to facilitate investigations.

Assist in preparing documentation for audits, compliance, and regulatory inquiries.

Maintain thorough documentation of investigations and communications with providers.

Stay updated on changes to coding guidelines and fraud detection methods.

Complete special projects and audits as required.

27973908EXPPLAT

Job Requirements

Required for Onboarding

• BLS
• Pharmacology
• Skills Checklist
• Specialty Exam

About Cynet Health

Your travel nursing adventure begins here. Matching talented nurses like you with high-paying travel jobs at the best facilities across all 50 states. We offer the most competitive pay for every position we fill. We understand this is a partnership. You will have no surprises. Your salary will be discussed upfront and there will be no troubling negotiation tactics.