Medical Review Nurse II - SNF/MDS Auditor

Job Summary:

• Primarily perform Skilled Nursing Facility medical claims audit reviews.
• Work remotely in a fast-paced, dynamic environment as part of a multi-location team.

Key Responsibilities:

• Audit claims for medically appropriate services in SNF settings.
• Generate letters articulating audit findings and support appeals.
• Work collaboratively with audit team and clients to improve policies.

Required Qualifications:

• Active unrestricted RN license with five years nursing experience.
• One year MDS/RAI process experience and medical records review.
• Expertise in ICD-9/ICD-10 coding and healthcare claims.

Our Mission:

• Constantly reimagine possibilities in healthcare.
• Drive down costs and maximize financial outcomes.
• Deliver disruptively simple and clear solutions.