RN/HEDIS Chart Review | Nurse & Healthcare Jobs in Houston | Registered Nurse Jobs

Nichele

RN/HEDIS Chart Review

Posted on Oodle - Over 4 weeks ago

Company:: All Medical Personnel

Location:: Houston, TX

Features & Description

All Medical Personnel is currently seeking Registered Nurses interested in HEDIS/Chart Review opportunities in Houston, TX! for a four week assignment. We have been asked by our client to locate the "Best of the Best" HEDIS Nurses for a great career opportunity!

Responsibilities include:

1) Provide accurate disposition of prior authorization requests submitted by providers for Medicaid fee-for-service recipients, involving specific services through analysis of abstract submissions, medical records, orders and related documentation
2) Review and apply criteria, collect, research and organize information to use in reviews.
3) Review and determine appropriateness of level or care requests and plan of care requests for these waiver services
4) Appropriately refer reviews not meeting criteria to peer consultants, including medical directors
5) Refer potentially fraudulent claims to management for further investigation
6) Maintain complete confidentiality of protected health information
7) Maintain effective communication with management regarding development within areas of assigned responsibilities
Requirements

Unrestricted Texas License and three years clinical experience
Effective communication skills
Time Management skills

We are looking to identify candidates quickly for this position so turn interest into action and apply today!

If you are interested please send your current resume in Word format to nichelew@allemedstaffing.com.

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