Friday, January 11, 2013

Quality Assurance RN(s) in the greater Boston area! Multiple locations.

HEALTHCARE IS CALLING! 

Job Description

Exciting Opportunities exist for QA/RN's at one of the state's premier agencies.
  • Responsible for reviewing clinical records to ensure compliance with agency policy, reimbursement requirements, maximization of utilization (both frequency and disciplines) and quality clinical standards of practice.
  • Conducts continuous utilization review of clinical records on a weekly basis to prepare for branch bi-weekly Medicare bills.
  • Participates in agency wide quality improvement activities including developing, implementing and maintaining educational training programs.

Desired Skills & Experience

Requirements
  • Knowledge of Medicare Program, coverage requirements and payment provisions (PPS & FFS)
  • Knowledge of Medicare appeals process and other health program funing/insurance eligibility. 
  • Knowledge of principles of utilization management.
  • Experience with OASIS a plus 
Please send resume to themadrecruiter@gmail.com for immediate consideration!  

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