usrn permanent wfh up to 200k sob job at ascentpro - Work from Home | workbankAscentPro

US Registered Nurse Hiring
Permanent WFH Set Up
Good compensation and Benefits
Up to 200k SOB - Up to 65k Monthly Salary
Qualifications:
Non Mainland Licenses are accepted
Those candidates with expired or inactive licenses can now be processed.
Candidates from other locations including Davao, Baguio, etc can now be endorsed
Experience of less than 1 year is accepted
Job Responsibilities:
Review Existing Clinical Documentation
Review/interpret clinical/medical records submitted from provider (e.g., office records, test results, prior operative reports) o Identify missing information from clinical/medical documentation, and request additional medical or clinical documentation as needed (e.g., LOI process, phone/fax)
Review and validate diagnostic/procedure/service codes to ensure their relevance and accuracy, as applicable (e.g., Prior Authorization List (PNL/EPAL), state grid, LCDs, NCDs)
Identify and validate usage of non-standard codes, as necessary (e.g., generic codes)
Apply understanding of medical terminology and disease processes to interpret medical/clinical records o Make determinations per relevant protocols, appropriate (e.g., approval, denial process, conduct further clinical or non-clinical research)
Review care coordinator assessments and clinical notes, as appropriate
Make Final Determinations Based on Clinical and Departmental Guidelines
Demonstrate understanding of business implications of clinical decisions to drive high quality of care
Understand and adhere to applicable legal/regulatory requirements (e.g., federal/state requirements, HIPAA, CMS, NCQA/URAC accreditation)
Ask critical questions to ensure member- and customer-centric approach to work
APPLY NOW AND START THIS JULY :)
Workbank

Baguio, Benguet
₱60,000 per month
Permanent
Full-time