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Utilization Review Nurse

Actalent

Location: Tampa, Florida
Type: Non-Remote
Posted on: May 16, 2022
This job is no longer available from the source.
Description:
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
Analyze and identify trends and provide reports as necessary
Consistently meet established productivity, schedule adherence and quality standards
Initiates various investigations
Request documentation and records from providers and vendors
Makes determinations on claims
Skills:
icd-10, CPT, medical terminology, Milliman, Interqual, Utilization review, Utilization management, Concurrent review, Prior authorization, Case management
Additional Skills & Qualifications:
RN
Claim review
Utilization review
ICD-10
CPT
Medical terminology
Interqual
Milliman
Appeals/denials
About Actalent:
Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We’re supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Employment Type: OTHER