RN Clinical Reviewer

CBIZ • Indianapolis, IN

1d • Remote

About The Position

This role involves reviewing resident medical records for accuracy, completeness, and consistency with professional standards. The RN Clinical Reviewer will participate in remote and on-site field examinations of Medicaid providers to review clinical documentation. The position requires successful interaction with providers in a professional manner, developing rapport and enhancing business relationships, while maintaining the security and confidentiality of all Protected Health Information (PHI). Additional responsibilities may be assigned.

Requirements

• High school diploma or GED
• Must be a licensed Registered Nurse (RN)
• Minimum 3 years of long term care experience required
• Proficient use of applicable software programs, including Microsoft Windows, Word, Excel
• Strong verbal and written communication skills
• Ability to manage multiple deadlines and prioritize assignments
• Ability to work in a team environment
• Well organized with a high degree of accuracy and attention to detail
• Must be able to travel based on client and business needs (up to 20% Travel)

Nice To Haves

• Bachelor’s degree in Nursing or other related health care field required (Associate’s Degree from accredited nursing school with related experience may be substituted in lieu of a bachelor’s degree)
• 5 years of long term care experience preferred
• MDS experience preferred
• Experience and knowledge of State and Federal healthcare regulations in long term care
• Knowledge of Medicaid reimbursement and coverage policies desired

Responsibilities

• Review resident medical records for accuracy, completeness and consistency with professional standards
• Participate in remote and on-site field examinations of Medicaid providers to review clinical documentation
• Successfully interact with providers in a professional manner, developing rapport and enhancing business relationships
• Maintain security of and confidentiality of all Protected Health Information (PHI)
• Additional responsibilities as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED