Nurse Auditor

Harrisburg, PA

Posted: 04/23/2024 Category: Nursing Job Number: MHamilton2

Job Description

A-Line Staffing is now hiring a Nurse Auditor Hybrid / Remote in Harrisburg PA.

If you are interested in this Nurse Auditor Hybrid / Remote position, please contact Marcia Hamilton at (586) 710-7979 or mhamilton@alinestaffing.com

Nurse Auditor Hybrid / Remote Compensation

  • The pay for this position is $31.00 per hour
  • Benefits are available to full-time employees after 90 days of employment
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Nurse Auditor Hybrid / Remote Highlights

  • This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
  • The required availability for this position is Nurse Auditor Hybrid / Remote
    Must work from the office in Harrisburg for 4-8 weeks for training and after training will work from the office 1 day a week and remote 4 days a week

Nurse Auditor Hybrid / Remote Responsibilities

  • A resource is responsible for the review and evaluation of medical information and examination of medical records and other documentation to assure that eligible medical assistance recipients receive appropriate and quality medical care that the Medical Assistance Program is properly billed and that provider and/or recipient fraud and abuse of the Medical Assistance Program is detected and corrected
  • Ability to communicate effectively verbally and in writing with coworkers management Office of General Counsel other agencies nursing facility staff and other medical assistance providers to review and discuss cases
  • Resources also provide advisory and consultative services to boards and staff designed to improve the services or administrative procedures in support of medical assistance patients
  • Ability to review and evaluate provider documentation to determine compliance with Medical Assistance regulations.

Nurse Auditor Hybrid / Remote Requirements

  • Registered Nurse issued by the Pennsylvania State Board of Nursing or Possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing
  • One-year period as a nurse defined by the Pennsylvania State Board of Nursing
  • Basic Computer Skills and writing
  • Three years of professional experience with medical assistance MA health care services or human services
  • Three years of recent within the last five years professional experience in one or more of the following areas as related to the position need: long term care acute care setting behavioral health setting drug and alcohol setting managed care quality management/utilization review or other related clinical experience
  • Or equivalent to combination of experience and training in the field of medical assistance MA health care services human services long term care utilization review or knowledge of home care
  • Attendance is mandatory for the first 90 days
  • Knowledge of and familiarity with the following would be beneficial: Inter- Qual criteria ICD-9 CM and current procedure terminology

Nurse Auditor Hybrid / Remote Preferred Qualifications

  • Microsoft Office Suite
  • 1+ year as a Registered Nurse issued by the Pennsylvania State Board of Nursing

If you think Nurse Auditor Hybrid / Remote position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!

Please contact Marcia Hamilton at (586) 710-7979 or mhamilton@alinestaffing.com

 

 

 

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About Harrisburg, PA

Discover exciting job opportunities in the vibrant Harrisburg, Pennsylvania area today! Situated along the scenic Susquehanna River, Harrisburg offers a perfect blend of historical charm, modern amenities, and endless opportunities for career growth. Immerse yourself in the rich culture of the State Museum of Pennsylvania, enjoy performances at the Whitaker Center for Science and the Arts, or cheer on the Harrisburg Senators at FNB Field. Indulge in local cuisine, stroll through picturesque Riverfront Park, or explore nearby Hershey, known as the "Sweetest Place on Earth." Join us in Harrisburg, where a fulfilling career and a fulfilling life await you. Explore our job listings now!