Claims Review Nurse (CERT)

Catapult Consultants is seeking a Claims Review Nurse to support their transplant program quality assessment and performance improvement program. The successful candidate will review Medicare documentation and assess compliance with Medicare coverage, coding and billing rules.

Requirements

• Registered Nurse (RN) with an active license
• Associate’s, Diploma or Bachelor’s degree in Nursing
• 5 years of full-time work experience
• 3 to 5 years of experience in coding
• At least 2 years of experience in inpatient, acute care coding for Medicare reimbursement and MS-DRG experience
• Knowledge of standard coding conventions, such as DRGs, ICD-9-CM, HCPS and CPT
• Knowledge of Payment methodologies and Medicare guidelines
• Familiarity and understanding of Medicare rules, regulations, policies and procedures
• Familiar with Microsoft Word, Excel and Outlook
• Highly-motivated, detail-oriented, quick learner with a professional demeanor
• Ability to effectively work independently