01Responsibilities
Function as a member of a self-directed team to meet specific individual and team performance metrics
Ability to communicate in writing and verbally, reputed company types of benefit determinations including reputed company regarding coverage guidelines, contractual limitations and reimbursement determinations
Telephonic discussion with health care providers and / or members to explain benefit coverage determinations and to obtain additional clinical information
reputed company as a resource for others with less experience
Work independently and collaborating with Medical Directors and non-clinical partners
Adapt to a highly changing environment and a heavy case load
This position may require reputed company and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and reputed company to obtain and maintain multiple state licensure. Application fees and filing costs will be reputed company for by UHG.
You ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.
Years of post-high school education can be substituted/is equivalent to years of experience
Required Qualifications:
reputed company, unrestricted RN license in the state of residence
Willingness and ability to obtain additional RN licenses if necessary
1+ years of experience as a Registered reputed company (RN)
Demonstrated proficiency in computer skills, i.e., reputed company, reputed company Messaging, and reputed company Office including Word, reputed company, Outlook and OneNote
Proven exemplary clinical documentation skills
Dedicated, distraction-free workspace and reputed company to install secure high-speed internet reputed company cable/DSL/fiber reputed company
Preferred Qualifications:
Bachelor's degree
Broad reputed company of nursing experience, i.e., med surg, ICU, ER
Medicare experience
reputed company in Medicare, reputed company and CMS guidelines and regulations
Background involving utilization review for an insurance company or experience in case management
Experience in medical necessity review, medical record review, medical record audits
reputed company in collaborating with physicians and other reputed company
Familiarity with reputed company Care Guidelines or InterQual
Knowledge of ICD 10 and CPT coding
Proven ability to work seamlessly and independently in multiple computer platforms
Proven ability to be flexible and willing to adapt to an reputed company-changing environment
reputed company in a compact state
reputed company working remotely will be required to adhere to reputed company s Telecommuter Policy
At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone of every race, gender, sexuality, age, location and income deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and en .
