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Change Healthcare RN, Clinical Review Specialist in Helena, Montana

Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.

Work Location:

  • Fully Remote - U.S.

    Position:

The Clinical Review Nurse is responsible for reviewing post service, pre-adjudicated claims, and records to identify aberrant coding and billing patterns including complex and forensic review of related medical records. No ICD-10 diagnosis experience needed. This unique position includes detailed chart review, a strong knowledge of CPT/HCPCS coding and a drive to research the unknown. Core Responsibilities:

  • Conduct clinical review of medical records

  • Manage workload that meets or exceeds production and quality goals and in a timely manner

  • Documents clinical review findings maintaining thorough, objective, and consistent reviews

  • Interface with other teams and indirectly with clients by correspondence to answer questions and resolve issues relative to review criteria

  • Participates in process improvement activities

    Requirements:

  • RN license required

  • 5+ years of clinical medical record/claim review experience

  • Knowledge of medical terminology

  • CPT & HCPCS Coding experience

    Preferred Qualifications:

  • Bachelor’s degree preferred; Master’s degree a plus

  • Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) preferred or will get certified within one year of employment

  • Knowledge of claims process

  • Knowledge of genetic testing or lab is a plus

  • Strong written and verbal communication skills

    Working Conditions/Physical Requirements:

  • General office demands

    Travel:

  • No travel required

    Unique Benefits*:

  • Flexible work environments

  • Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets

  • Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships

  • Employee wellbeing programs and generous health plans

  • Educational assistance programs

  • US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions

  • Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies

  • Learn more at https://careers.changehealthcare.com

  • *Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.

    Diversity and Inclusion:

  • At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.

  • Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity

    Feeling Inspired? Ready to #MakeAChange? Apply today!

    #li-remote

New York and New Jersey Residents Only: The salary range for New York City, NY and Westchester County, NY is $77,280 - $134,400. The salary range for Ithaca, NY is $67,200– $112,000. The salary range for Jersey City, NJ is $80,640 – $134,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, Change Healthcare offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with Change Healthcare, you’ll find a far-reaching choice of benefits and incentives.

Diversity, Equity & Inclusion :

•At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.•Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity Feeling Inspired? Ready to #MakeAChange? Apply today!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety and well-being of our team members and our communities. As such, some individuals may be required to disclose COVID-19 vaccination status prior to or during employment. Certain roles may require COVID-19 vaccination and/or testing as a condition of employment. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (https://www.changehealthcare.com/privacy-notice/privacy-notice-to-california-job-applicants) .

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

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