Registered Nurse / RN - Review & Evaluation (9475)
Company: InGenesis, Inc
Posted on: April 5, 2021
Registered Nurse / RN - Review & Evaluation (9475) Registered
Nurse / RN - Harrisburg, PA - Contract Job Description InGenesis is
currently seeking a Registered Nurse / RN to work with our client
located in Harrisburg, PA. In this role, you will review and
evaluate medical information/records to assure the medical
necessity, appropriateness, and quality of care and services under
the Medical Assistance Program. If you meet the qualifications
outlined below, apply today and we'll reach out to answer any
questions you may have! Job Duties
- Detect and correct provider or recipient fraud and abuse.
- Analyze and evaluate provider documentation.
- Provide problem solving solutions to improve services or
- Approve and deny request.
- Refer requests to physician, as needed.
- Enter data and decision into computerized system.
- Evaluate appeal request and medical records.
- Prepare cases, exhibits, and appeal correspondence.
- Testify at appeal hearings.
- Interpret MA policies, regulations, and procedures.
- Attend staff meetings.
- File and retain records.
- Perform other duties as necessary or assigned. Minimum
- Current Registered Nurse / RN license issued by the state of
- 3+ years of professional experience with medical assistance,
health care services, or human services.
- May accept any equivalent combination of experience and
- Basic computer skills, including familiarity with Microsoft
Office programs. About InGenesis InGenesis is dedicated to placing
people in positions that preserve life, improve lives and inspire
others. This does not happen without passionate people, skilled
colleagues who are motivated to create innovative solutions and
deliver superior service to our clients. Founded in 1998, InGenesis
manages thousands of employees, including pioneering healthcare,
science, technology and pharma professionals. The workforce
solutions company includes almost half of the Fortune 500 in its
nearly 300 clients. It is recognized as one of the largest
healthcare staffing firms, and InGenesis is the largest
minority/women owned healthcare staffing firm in North America.
EEOC Statement InGenesis is proud to be an affirmative action
employer and is committed to providing equal employment opportunity
regardless of race, color, ancestry, religion, sex, national
origin, sexual orientation, age, citizenship, marital status,
disability, gender identity, or Veteran status. If you have a
disability or special need that requires accommodation, please let
us know by visiting our website at
Keywords: InGenesis, Inc, Harrisburg , Registered Nurse / RN - Review & Evaluation (9475), Healthcare , Harrisburg, Pennsylvania
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