What are the responsibilities and job description for the Medical Claims Review RN position at MedNational Staffing?
Job Opportunity : Claims Repricing Specialist
Remote – Must Reside in One of the Following States : AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater NYC), OH, TX, UT, WA (outside greater Seattle), WI
Pay Rate : $20.07 / hour
Schedule : Monday – Friday, 8 : 00 AM – 4 : 30 PM (Your Local Time)
Potential for Temp-to-Perm for the Right Candidate
About the Role :
Our client is seeking a Claims Repricing Specialist to review and analyze medical claims for payment integrity audits, ensuring accurate pricing based on insurer policies, contracts, and reimbursement schedules. This role requires attention to detail, problem-solving abilities, and strong analytical skills to ensure efficient and compliant claims processing.
Key Responsibilities :
Repricing Claims :
- Utilize claims processing systems to review and reprice claims.
- Apply appropriate pricing methodologies for Medicare, Medicaid, PPO, and HMO networks.
- Document and communicate pricing changes effectively.
Claims Review & Analysis :
Communication & Collaboration :
Problem Solving :
Qualifications & Skills :
Medical billing codes (CPT, ICD-10, HCPCS)
Additional Requirements :
Candidates must have dual monitors and a docking station for optimal performance.
If you meet the qualifications and are eager to apply your expertise in a dynamic healthcare claims environment, apply today! 🚀
Salary : $20
