What are the responsibilities and job description for the Retrospective Utilization Review Nurse position at Adecco US, Inc.?
Adecco Healthcare & Life Sciences is hiring Retrospective Utilization Review nurses! This role is in remote / work from home. Please read below and apply with an updated resume for consideration :
Type : Three-month contract, opportunity for extension or fulltime offer
Schedule : Monday through Friday, 8am to 5pm EST
Pay : $40.30 to $43.30 an hour
Responsibilities of the Retrospective Utilization Review Nurse :
- Provides retrospective clinical review according to state and medical necessity criteria using InterQual guidelines.
- Demonstrates ability to critically think and follow documented processes for supporting the clinical appellate process.
- Adheres to the department standards for productivity and quality goals. Ensuring accounts assigned are worked in a timely manner based on the payor guidelines.
- Performs follow-up on initial denials received from payors on retrospective clinical reviews by first level of appeal submission.
- Ensure Diagnosis and Procedure codes align with services performed and communicate discrepancies to appropriate contacts per workflow process.
- Perform other related tasks as assigned by supervisor or manager and maintains department productivity and quality measures.
- Attends regular staff meetings, always conducts self in a professional manner, and completes assigned work objectives and projects in a timely manner.
Knowledge, Skills and Abilities :
Qualifications for the Retrospective Utilization Review Nurse :
Why work for Adecco?
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
IMPORTANT : This Retrospective Utilization Review Nurse job is being recruited for by Adecco’s Healthcare & Life Sciences division, not your local Adecco Branch Office.
For opportunities available at Adecco Medical and Science go to www.adeccousa.com / industries / medical-and-science
Equal Opportunity Employer / Veterans / Disabled. To read our Candidate Privacy Information Statement, which explains how we will use your information, please visit http : / / www.adeccousa.com / candidate-privacy / . The Company will consider qualified applicants with arrest and conviction record
Pay Details : $40.30 to $43.30 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer / Veterans / Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https : / / www.adecco.com / en-us / candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and / or security clearance requirements, including, as applicable :
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
Salary : $40 - $43
