AIS- National Nurse Reviewer at Woodbridge

Job Description

JOB SUMMARY:

The National Nurse Review position provides support to the carriers personnel regarding medical care, medical necessity, relatedness and causality. This is a retrospective review.

MAJOR DUTIES AND RESPONSIBILITIES:

• Review bills including HFCAs and UB92s on injured parties, involved in Automobile Accidents Cases
• Perform utilization review in accordance with AIS structure
• Determine if the bill requires physician review.
• Review of certain coding rules
• Will be required to cross train into other areas
• Other duties as assigned

Concentras Data Protection Commitment
* Concentra is committed to protect patient data and to ensure privacy of personal and medical information.
* Every Concentra colleague has the responsibility to adhere to data protection principles.
* If a colleagues role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.

Job Requirements

QUALIFICATIONS:

• BSN/RN
• Current and unencumbered license in the state of residence
• ABQAURP certification preferred/ or will be required to take and pass the test
• Auto claims experience preferred
• Excellent communication skills, both verbal and written
• Ability to handle multiple tasks
• Ability to work under moderate supervision
• Ability to work in a home environment (requires broadband internet access such as cable or Verizon FIOS DSL and Satellite are not acceptable)
• Knowledge of computer programs, emails, word is helpful

Country: USA, State: New Jersey, City: Woodbridge, Company: Concentra.