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Position: Registered Nurse (RN) Position Type: Long-Term, Temporary (up to 2 years) Location: Albany, NY Hours: 8:30 am to 4:30 pm/9:00 am to 5:00 pm Salary: $35-60 per hour, depending on experience
Requirements:
This positions is assigned to the Medical Prior Approval Unit and will use the claims processing system and other electronic references to perform pre-payment, post-service adjudication of claims that pend for medical review.
Requires the use of professional medical judgment in the examination of claims and provider submitted documentation to substantiate the medical necessity for the requested services.
Involves utilizing national standards for procedure and diagnosis coding, reviewing appropriate combinations of medical services, and identifying methods to prevent fraud and abuse.
Requirements:
Current licensed as registered professional nurse in NYS
Three years post licensure professional nursing experience, at least two years which must have been in a licensed healthcare facility.
Experience in prior approval of medical supplies/equipment/services or experience in examination of medical records, documentation, and proposed treatment plans for medical necessity
Experience with national standards for procedure and diagnosis coding is preferred
Previous claims experience preferred but not required
Nursing home surveillance/case management experience is preferred but not required
Experience with Microsoft Office
Proficient in the use of standard office technology
Ability to be flexible, innovative, and work in a team environment
For more than thirty years, Penda Aiken, Inc. has committed itself to serving New York State, solidifying our position as a leading talent acquisition firm in the Northeast. Our team of industry experts collaborates closely with top-tier companies and exceptional candidates, providing personalized guidance to ensure the best possible results for everyone involved.
Partnering with Penda Aiken Inc. means positioning yourself for success. We provide access to competitive compensation, comprehensive benefits such as healthcare and dental coverage, a 401(k) plan, and paid time off (PTO), all delivered with personalized attention.
Penda Aiken, Inc. is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law.
Ready to take the next step in your career? Explore our job opportunities in the vibrant Albany, New York area! Known for its rich history, stunning architecture, and thriving arts scene, Albany offers endless opportunities for professional growth. Whether you're strolling through Washington Park, catching a show at The Egg, or indulging in local delicacies like chicken riggies or spiedies, Albany's charm and unique culture will make your career journey even more rewarding. Join us in this dynamic region and discover why Albany is not just a job location but a place to thrive!
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