Nurse Reviewer | Medical Coding, Billing, Claim, Clinical Expertise | V3 Staffing

3.0 - 8.0 years

10 - 12 Lacs

Hyderabad

Work from Office

Our reputed MNC Client is hiring for Nurse Reviewer role: Shift: 11:30 AM - 8:30 PM Work Mode: Work From Office (5 days) Location: Hyderabad Job Summary: We are seeking an experienced Nurse Reviewer to conduct in-depth claim reviews based on medical guidelines, clinical criteria, and billing rules. The ideal candidate will have a strong understanding of medical coding, clinical experience, and excellent communication skills. Key Responsibilities: - Conduct claim reviews to identify areas with savings potential - Review and validate charges against medical documentation - Contact medical providers to resolve billing inconsistencies - Manage claims reports and prioritize according to client stipulations - Maintain production metrics and quality assurance scores Requirements: - Current RN/LPN license - Varied clinical experience (Med/Surgery, ICU, Emergency Medicine) - Understanding of hospital coding and billing rules - Experience in medical claims review and audit techniques - Excellent communication and organizational skills Preferred Qualifications: - Background as a nurse or doctor - 4-5 years of hands-on experience in medical coding - Strong understanding of medical coding related to post-operative care, joint replacement, spinal surgery, and cardiac surgery procedures Warm Regards, Gayatri Kumari Email Id: gayatri@v3staffing.in V3 Staffing Solutions

Posted 1 month ago

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