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Registered Nurse Clinical Policy Specialist
A company is looking for a Clinical Policy Specialist, Remote in the US. Key Responsibilities Develop new clinical and coding products, enhancing audit strategies and claim selection processes Analyze data and conduct research to support the development of coding and clinical targets Monitor program performance and recommend changes to improve outcomes Required Qualifications Bachelor's degree in health administration, business, nursing, or 10 years of relevant experience Active and unrestricted Registered Nurse license Experience with coding audit principles and payment integrity programs 5+ years of experience in healthcare policy and regulation research 3+ years of experience in claims auditing and recovery auditing
A company is looking for a Clinical Policy Specialist, Remote in the US.
Key Responsibilities
Develop new clinical and coding products, enhancing audit strategies and claim selection processes
Analyze data and conduct research to support the development of coding and clinical targets
Monitor program performance and recommend changes to improve outcomes
Required Qualifications
Bachelor's degree in health administration, business, nursing, or 10 years of relevant experience
Active and unrestricted Registered Nurse license
Experience with coding audit principles and payment integrity programs
5+ years of experience in healthcare policy and regulation research
3+ years of experience in claims auditing and recovery auditing