Bill Review Nurse
Company: Conduent, Inc.
Posted on: May 14, 2019
Overview As a member of the corporate team, you?ll focus on
enhancing the relationship with our clients as we provide
outstanding business solution services. Within departments like
Accounting & Finance, Human Resources, and Engineering, Conduent is
actively staffing all teams with roles like Recovery Analyst,
Client Services Specialist, and Senior Management Consultant. At
Conduent, we give our employees the opportunity to further develop
their career skills with the intention of growing them into leaders
within the organization.
- Full Time
- Professional Development Opportunities Success Profile What
will make you successful at Conduent? Check out the traits we?re
looking for and see if you have the right mix.
- Adaptable 9
- Detail-Oriented 9
- Multi-Tasker 8
- Strategic 10
- Expressive Presenter 6
- Conceptual 4 Traits are on a scale of 1 to 10 Addtional Traits
- Versatile Rewards
- Healthcare Conduent is proud to offer comprehensive and
competitive benefits that reflect the value of our employees.
Benefits will differ by country, please contact your recruiter for
details specific to your location.
- Balance Maintaining a work/life balance is the key to
- Collaboration Department learning opportunities and
company-wide digital knowledge share.
- Compensation Competitive salaries.
- Family Support Additional resources to support employees with
- Professional Development Conduent offers programs to help
advance the careers of our employees. Responsibilities Description
Conduent is the world's largest provider of diversified business
process services with leading capabilities in transaction
processing, automation, analytics and constituent experience. We
work with both government and commercial customers in assisting
them to deliver quality services to the people they serve. We
manage interactions with patients and the insured for a significant
portion of the U.S. healthcare industry. We are the customer
interface for large segments of the technology industry and the
operational and processing partner of choice for public
transportation systems around the world. Whether it's digital
payments, claims processing, benefit administration, automated
tolling, customer care or distributed learning - Conduent manages
and modernizes these interactions to create value for both our
clients and their constituents. Learn more at www.conduent.com. Job
Summary:The Medically Managed Bill Review Nurse is responsible for
retrospective utilization management activities per specified state
bill review guidelines and Bunch bill review protocols.? He/she is
responsible for the audit of complex medical bills to review
utilization of services, as well as medical necessity, and to
assess the appropriateness of charges.Minimum Qualifications:
- LPN/LVN with two years clinical nursing experience.
- Knowledgeable in computer operations, including Windows
operating system, data entry skills and 10-key capabilities.
- Knowledge of ICD-9 and CPT coding procedures.
- Previous nursing roles dealing with specialties: in
Occupational Health, Orthopedics, Hospital, Surgery Center,
- Must demonstrate the ability to understand state laws and
utilization guidelines as they apply to bill review activity.
- Active and unencumbered professional license.Essential
- Demonstrates basic problem solving skills to ensure early
intervention and identification of those injuries which will
benefit from medical case management or to identify questionable
claims during the retrospective bill review process.
- Demonstrates basic knowledge of UR process.
- Demonstrates basic knowledge of ICD-9 coding.
- Demonstrates basic knowledge of HCFA billing and CPT and HCPCS
- Demonstrates basic knowledge of UB billing, Primary Procedure
codes, revenue codes and jurisdictional direction regarding
- Demonstrates basic knowledge of CCI edits.
- Review of complex HCFA bills to determine authorization,
relation to injury and appropriateness of service.
- Review of complex UB bills to determine authorization, relation
to injury and appropriateness of service
- May refer high dollar bills to BR department for advanced
negotiation as identified in negotiation protocol.If this describes
you, the timing is right, AND you HAVE the required skills &
experience, please apply/send resume to??Leonard Price?at [Click
Here to Email Your Resum?]?.Conduent is an Equal Opportunity
Employer and considers applicants for all positions without regard
to race, color, creed, religion, ancestry, national origin, age,
gender identity, gender expression, sex/gender, marital status,
sexual orientation, physical or mental disability, medical
condition, use of a guide dog or service animal, military/veteran
status, citizenship status, basis of genetic information, or any
other group protected by law. People with disabilities who need a
reasonable accommodation to apply for or compete for employment
with Conduent may request such accommodation(s) by clicking on the
following link, completing the accommodation request form, and
submitting the request by using the 'Submit' button at the bottom
of the form. For those using Google Chrome or Mozilla Firefox
please download the form first: click here to access or download
Keywords: Conduent, Inc., Amarillo , Bill Review Nurse, Other , Amarillo, Texas
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