RN – Chart Review RN25-30718

Job Title: RN Chart Review
Location: Phoenix AZ 85034
Type: Contract
Shift: MondayFriday 8:00 AM 5:00 PM(40 hours/week no weekends overtime not currently approved).
Pay Rate: $30$33/hr

Job Summary:

Navitas Healthcare LLC is seeking RN Chart Reviewfor an exciting job in Phoenix AZ.

Requirements:

• Active RN license.

• Behavioral Health experience (outpatient preferred).

• Fingerprint clearance card preferred; if not current initiation will be required.

• Ability to work remotely with provided computer setup.

Responsibilities:

• Review and adjudicate medical claims using industry standards.

• Evaluate claims against prior authorizations and UB claims.

• Determine appropriate level of care and length of stay for recipients.

• Prepare reports and analyze trends and savings.

• Conduct special projects and research as required.

• Collaborate with other departments and healthcare providers as needed.

Required Knowledge & Skills:

• Medical nursing practice and case management protocols.

• Quality management and utilization review processes.

• Knowledge of healthcare delivery systems and managed care processes.

• Acute nursing processes: assessment planning intervention and evaluation.

• InterQual Criteria CCI CPT HCPCS and ICD-9 coding.

• Medical claims review and statistical analysis.

• Computer data retrieval and input.

• Interpretation of governmental regulations and rules.

• AHCCCS rules and regulations.

For more details contact at or Call / Text at .

About Navitas Healthcare LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.