Nurse Medical Mgmt I
Posting ID: JP-002664518
- Actalent Scientific is actively interviewing for fully remote nurse medical managers in the Indianapolis area! Candidates are responsible for collecting member records and conduct reviews of these records by contacting providers and placing the results collected into a specific data base. This candidate will be required to handle a high volume of telephonic interaction with provider offices. Candidates must follow up on requested medical records with providers.
- Must keep excellent documentation of research and contact information.
- Candidate must pass a medical record abstraction test prior to starting actual record reviews after 4-8 weeks of training.
- These opening are all on first shift working Monday-Friday offering above market pay value with one of the largest healthcare companies in the state!
Please send your resume to email@example.com
Major Duties and Responsibilities:
- This is a high production environment and candidates must adhere to measured productivity requirements, module testing and at times retesting to meet minimum requirements.
- Required to perform research on internal claims systems.
- Work under the supervision of our clients internal staff and designated lead in order to achieve goals and keep the project moving.
- Candidates must have critical thinking skills as they will conduct research in a thoughtful and methodical search in order to locate specific claim information.
- Research includes all resources provided in order to find best information.
- Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
- Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process.
Additional Skills & Qualifications:
- Must have a ASN or BSN with active IN RN or compact RN license
- Assistant to physician and nurses in reviewing of medical records, applying codes for billing/claims, processing files and submitting to insurance or other requested agencies.
We have interview times for this week and next week only; and times are filling quickly. If you or any friends/family are interested in hearing more about these opportunities, apply today and reach out to me directly firstname.lastname@example.org AS SOON AS POSSIBLE!
Compensation is tied to the Colorado market for jobs performed in Colorado. Other locations may be subject to variances based on locations-related factors. We reserve the right to pay above or below the posted wage based on factors unrelated to sex, race, or any other protected classification.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. This temporary role may be eligible for the following:
- Medical, dental & vision
- Insurance (Basic/Supplemental Life & AD&D)
- Short and long-term disability
- Health & Dependent Care Spending Accounts (HSA & DCFSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We’re supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Recruiter: Karlecia Ross