RN - Compliance Clinical Analyst
Location: Minnetonka Minnesota
Description: Clinicor is hiring RN - Compliance Clinical Analyst right now, this position will be placed in Minnesota. For detail informations about this position opportunity please give attention to these descriptions. This position plays an integral role in ensuring claim integrity as it supports all recovery efforts for the Claims Operations team.
Fulfilling the duties of this positi! on accurately, effectively and in a timely manner directly affects the recovery of claim payments made due to wasteful and abusive billing patterns.
The Post-Pay Compliance Analyst will analyze and trend recovery patterns to look for process improvement opportunities and will submit recommendations in writing to the internal customers and external vendors in which the reviews are being performed and report to management.
This position will also be responsible for representing Recovery Claims Operations at interdepartmental and external departmental meetings. Various large projects throughout the year are to be managed by, or largely supported through this position included but not limited to, waste, abuse and recovery.
This position must collaborate with staff from various departments as well as external clients to ensure prompt and appropriate action is taken regarding any claims in question.
This position must also have a strong understanding of ! healthcare, medical claim billing standards, recovery practice! s, as well as vendor management, operational functions and company operations to be successful in the role.
In addition, this position requires the ability to actively manage multiple projects simultaneously and strong organizational, analytical and problem solving skills. Solid verbal and written communication and interpersonal skills are required to effectively collaborate with other internal departments as well as external parties.
ESSENTIAL QUALIFICATIONS/REQUIREMENTS:
EDUCATION/EXPERIENCE:
Education Level: Bachelor’s or Associates Degree
Major: Registered Nurse
Years of experience required: 3 years
Specific types of experience required:
Four-year degree and/or equivalent work experience
3 years recovery and/or clinical auditing/analytic experience
CPT coding experience
Health care claims experience
Background in clinical review of claims
Ho! spital nursing
Specific types of experience preferred:
Certified Professional Coder (CPC), preferred
COSMOS (United Healthcare only system) claims processing experience preferred
REQUIRED CERTIFICATIONS/LICENSURE:
Registered Nurse
Monday through Friday 8am to 5pm
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Clinicor.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Wed, 07 Aug 2013 17:36:17 GMT