Utilization Nurse Information

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CorVel Corp.

CorVel Corporation is a national provider of industry-leading workers’ compensation solutions for employers, third party administrators, insurance companies, and government agencies seeking to control costs and promote positive outcomes. We apply technology, intelligence, and a human touch to the challenges of risk management so our clients can intervene early and often while being connected to the critical intelligence they need to proactively manage risk. With a robust technology platform a... Read More

Address	801 Cherry Street, Fort Worth, TX 76102
Website	www.corvel.com/
Holding	No Holding Details

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Utilization Nurse

Seeking a full time Nurse Auditor to perform on-site post payment audits at community based Agencies providing Personal Care Services to North Carolina Medicaid recipients. The position involves retrieval and audit of medical records to determine whether the services were provided in accordance with NC Medicaid coverage and billing policies and to ensure charges are supported by clinical documentation. May include participation in hearings to review audit findings. Ability to travel statewide on a weekly basis with overnight stays (Tuesday –Thursday). Ability to work as part of a team and independently with minimal supervision.
Essential Job Duties:    Travel statewide in NC to Community based Home Care Agencies as part of a team of 2 nurses. Secure specified agency documents on-site, scan, and perform initial audit functions. Discuss with designated personnel at agency, preliminary audit findings and trends. RN will audit documents to determine documentation supports billing as well as services were provided in accordance to NC Medicaid policy. Audits will be completed in north Raleigh office. Attend hearings as scheduled and communicate(oral and written) audit findings to participants.
Education/Training Requirements:    Current Unencumbered NC Registered Nurse License. Previous retrospective utilization review or audit experience preferred. Minimum of 5 years clinical experience, which includes a minimum of 3yrs. in Home Health Services. Must have excellent verbal and written communication skills; ability to speak clearly and concisely, to convey complex or technical information. Strong computer proficiency - Windows 10, Word, Excel, and Outlook required.
Application Instructions:    Fax resume to the attention of J. Schumer@ 866-434-0552

Other Job Information

Vacancy type:	Full Time	Contact Mode:	not provided
Fax:	949-851-1469	Contact Name:	not provided
Job Duration:	not provided	Phone:	949-851-1473
Email:	marketing@corvel.com