RN Case Manager - REMOTE
Horizon Healthcare Staffing is seeking a full time RN Case Manager to work REMOTELY from home, Monday through Friday 8am-5pm schedule.
The nurse provides support to the carrier’s personnel regarding medical care, medical necessity, relatedness and causality. This is a retrospective review.
- Review bills including HFCA’s and UB92’s 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
- Mon-Fri 8am-5pm schedule. 40 hours per week. Completely remote position.
- Other duties as assigned
Requirements / Qualifications:
- Must have a valid state RN license.
- Does not need to have a NJ license (though it is preferred).
- A compact license would also be preference.
- Individual with insurance claims background. Automotive claims is a plus.
- Utilization review, case management, InterQual guideline background are all highly desired.
- Someone with a HCQM (Health Care Quality Management) certification through ABQAURP would be awesome, but not required.
- 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, excel and word