Registered Nurse Appeals Analyst
Elara Caring · Dallas, Texas, US
At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a...
Job description
At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. Job Description: REMOTE POSITION!!! MUST HAVE HOME HEALTH & HOSPICE EXPERIENCE: JOB SUMMARY: The Appeals Analyst performs medical record reviews to determine the quality of care, identifies quality issues , and assures compliance with medical record standards and regulatory mandates as related to billing compliance . The incumbent analyzes submitted claims and/or claims to be submitted as well as medical re cords to determine benefit coverage for medical services under review. This position educates providers on all aspects of medical record criteria to determine benefit coverage for medical services. This position prepares written documents and/or reports of completed medical review determinations and submits records to the payer, as requested. JOB REQUIREMENTS: E DUCATION: Must be a g raduate from an accredited nursing school . A Bachelor’s Degree in Nursing...