Nurse Reviewer

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Bachelor's degree in nursing or a related field., 3-5 years of experience in medical claims review or a related role., Strong communication and analytical skills are essential., Preferred certifications include Registered Nurse (RN) License and Certified Professional in Healthcare Quality (CPHQ)..

Key responsibilities:

  • Review medical claims for compliance with company policies and legal practices.
  • Conduct management reporting and maintain source documents.
  • Communicate effectively with clients and team members.
  • Maintain professional etiquette and organizational abilities.

Epiq Systems (Private) Limited logo
Epiq Systems (Private) Limited Computer Hardware & Networking TPE https://epiqsystems.lk/
11 - 50 Employees
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Job description


It's fun to work at a company where people truly believe in what they are doing!

Job Description:

Job Summary

The Nurse Reviewer is responsible for reviewing medical claims, ensuring compliance with company policies and legal practices. This role requires strong communication, confidentiality, and analytical skills.

Essential Job Responsibilities

  • Review medical claims and ensure compliance with company policies and legal practices.

  • Conduct management reporting and maintain source documents.

  • Communicate effectively with clients and team members.

  • Maintain professional etiquette and organizational abilities.

Qualifications & Requirements

Education: 

  • Bachelor's degree in nursing or a related field.

Experience: 

  • 3-5 years of experience in medical claims review or a related role.

Skills:

  • Communication

  • Company Policies

  • Confidentiality

  • Languages

  • Legal Practices

  • Management Reporting

  • Source Documents

  • Standard Operating Procedure (SOP)

  • Supervision

  • Written Communication

Certifications:

  • Required: None

  • Preferred: Registered Nurse (RN) License, Certified Professional in Healthcare Quality (CPHQ), Legal Nurse Consultant Certified (LNCC)

Physical Requirements: 

  • Ability to work in an office environment and perform tasks that may require sitting, standing, and using office equipment.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

It is Epiq’s policy to comply with all applicable equal employment opportunity laws by making all employment decisions without unlawful regard or consideration of any individual’s race, religion, ethnicity, color, sex, sexual orientation, gender identity or expressions, transgender status, sexual and other reproductive health decisions, marital status, age, national origin, genetic information, ancestry, citizenship, physical or mental disability, veteran or family status or any other basis protected by applicable national, federal, state, provincial or local law. Epiq’s policy prohibits unlawful discrimination based on any of these impermissible bases, as well as any bases or grounds protected by applicable law in each jurisdiction. In addition Epiq will take affirmative action for minorities, women, covered veterans and individuals with disabilities. If you need assistance or an accommodation during the application process because of a disability, it is available upon request. Epiq is pleased to provide such assistance and no applicant will be penalized as a result of such a request.  Pursuant to relevant law, where applicable, Epiq will consider for employment qualified applicants with arrest and conviction records.

Required profile

Experience

Industry :
Computer Hardware & Networking
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Client Confidentiality
  • Communication
  • Analytical Skills
  • Supervision
  • Organizational Skills

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