Nurse Reviewer I

2 weeks ago


Atlanta, Georgia, United States Zelis Full time
Job Summary

Zelis is seeking a skilled Nurse Reviewer I to join our team. As a key member of our revenue cycle team, you will be responsible for conducting thorough reviews of healthcare claims to ensure accuracy and compliance with industry guidelines.

Key Responsibilities
  • Conduct in-depth reviews of healthcare claims to identify potential errors or discrepancies
  • Apply clinical knowledge and expertise to evaluate medical records and coding practices
  • Collaborate with cross-functional teams to resolve claim issues and improve revenue cycle efficiency
  • Stay up-to-date with industry developments and regulatory changes to ensure compliance
  • Develop and maintain strong relationships with healthcare providers and payers
Requirements
  • 3-5 years of experience in healthcare claims review, auditing, or a related field
  • Strong clinical knowledge and expertise in medical coding and billing
  • Excellent analytical and problem-solving skills
  • Ability to work independently and as part of a team
  • Strong communication and interpersonal skills
What We Offer
  • A dynamic and supportive work environment
  • Opportunities for professional growth and development
  • A competitive salary and benefits package
  • A chance to work with a leading healthcare technology company

Zelis is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion.


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