Clinical Claim Review RN - Office Based, Omaha, NE (RN Required)

Apply Now
Company:
 
UnitedHealth Group
Company Profile | Current Opportunities (52)
Job Location(s): Omaha
Employment Term: Regular
Employment TypeFull Time
Start Date:As soon as possible
Starting Salary Range:Not Provided
Required Experience: Open
Related Categories:Healthcare - Nursing, Insurance - Management, Insurance - Claims

Position Description

Clinical Claim Review RN - Office Based, Omaha, NE (RN Required)-332507
Description
Ovations is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
Imagine joining a group of professionals and clinicians who are working to improve health care for people over 50. Consider the influence you can have on the quality of care for millions of people. Now, enhance that success with enthusiasm you can really feel.


That's how it is at Ovations. Everyday, we're collaborating to improve the health and well being of the fastest growing segment of our nation's population. And we're doing it with an intense amount of dedication.


Here, you will discover a culture that grows through challenge. That evolves by being flexible. That succeeds by staying true to our mission to make health care work effectively and efficiently for seniors. Put your best to work for us, and discover extraordinary opportunities for growth.
We're seeking a motivated RN with a background in quality to join our growing team. As the Clinical Claims Reviewer, you would review and audit facility claims. This position offers the opportunity to work on a variety of projects and enjoy flexible hours within a thriving Fortune 50 Company. If you are ready to demonstrate your medical coding skills with an industry leader where innovation and career growth are encouraged, we invite you to apply today.
Primary responsibilities of the Clinical Claims Reviewer include:
  • Troubleshooting local and national appeal issues for Medicare claims
  • Conducting claim review audits
  • Reviewing claims for accuracy and medical necessity
  • Generating reports
  • Training new team members
  • Working on special projects as assigned
Discover how fulfilling it is to work among more than 75,000 people who are as committed, driven, intelligent and passionate as you. Put your heart into a career with Ovations.
Qualifications
The requirements for this role are as follows:
  • An RN with a current an unrestricted license in the State of Nebraska
  • 3 years of experience in a acute care clinical setting
  • Solid CPT, HCPS and ICD-9 codes experience
  • A background in quality
  • Experience generating reports
  • MS Office proficiency
  • Excellent communication skills
  • A BSN degree, or equivalent work experience
Additional assets include:
  • Clinical claims experience
  • Auditing experience
  • A background working in a hospital setting
  • Medicare reimbursement policy knowledge
  • Certification in coding
  • Experience supporting the payment policy on the payer or provider side



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Job Clinical Claims Review
Primary LocationUS-NE-Omaha
Organization Ovations - Clinical
Schedule Full-time
Number of Openings 3

Apply Online Now

 

Please provide feedback on any problems or issues you may encounter.  NOTE: The feedback provided is sent to the NebraskaJobNetwork.com Web site team NOT the company posting this position. 
Indicates required fields