Title: Medicare Advantage RN Review Analyst
Location: Detroit, MI (Remote – Must be local to Michigan)
Duration: 12+ Months
Role Type: W2 Contract role
Max Pay Rate: $36/HR
Schedule: Monday – Friday 9-5
SUMMARY
Responsible for the approval or rejection of claims and/or benefit interpretation. May be required to enter or reference data via PC and/or Clinical Review Team terminal.
REQUIREMENTS
- Registered Nurse with current Michigan Registered Nurse License.
- Associate degree or nursing diploma required, bachelor’s degree preferred.
- Two (2) years RN patient care experience.
- Triage, case management and/or rehabilitation experience preferred.
- Medicare Advantage Part B experience a plus.
- Expertise in the use of medical terminology.
- Finely honed critical thinking skills are a must.
- Knowledge of CPT/HCPCS coding and Medicare regulations desirable.
CERTIFICATES, LICENSES, REGISTRATIONS
- Current unrestricted state of Michigan registered nurse license required.
*Beware of scams. S3 never asks for money during its onboarding process