Medical Review Nurse Analyst (RN) - REMOTE

WPS Health Solutions is seeking a dedicated and detail-oriented Medical Review Nurse Analyst (RN) to join our remote team. In this role, you will be responsible for reviewing medical records, analyzing clinical data, and ensuring compliance with healthcare regulations and policies. You will collaborate with healthcare professionals, ensuring that medical reviews are thorough, accurate, and in line with industry standards.

Key Responsibilities:

Perform medical record reviews to evaluate clinical data for accuracy and completeness.
Analyze healthcare claims and medical documentation to ensure proper coding and compliance.
Identify patterns and trends in medical data to improve healthcare quality and processes.
Provide expert guidance to teams regarding clinical practices, procedures, and regulatory requirements.
Collaborate with internal teams and healthcare providers to resolve discrepancies and clarify medical records.
Document findings and recommendations in a clear and comprehensive manner.
Stay up-to-date with changes in healthcare regulations, standards, and best practices.

Qualifications:

Registered Nurse (RN) with an active and unrestricted state license.
Experience in medical review, case management, or a similar clinical role is preferred.
Strong knowledge of medical terminology, clinical practices, and healthcare regulations.
Exceptional attention to detail and ability to analyze complex medical data.
Ability to work independently and manage multiple priorities effectively.
Excellent communication skills, both written and verbal.

Preferred Skills:

Experience with medical coding and reimbursement processes.
Knowledge of HIPAA regulations and healthcare compliance standards.
Familiarity with electronic health records (EHR) systems.

Why WPS Health Solutions? At WPS Health Solutions, we prioritize providing an inclusive and supportive work environment that fosters professional growth and work-life balance. As a remote position, you'll have the flexibility to manage your work schedule while making a meaningful impact on the healthcare industry.

Join Us: If you are passionate about healthcare and thrive in a collaborative and dynamic remote environment, apply today to join our team at WPS Health Solutions!

How to Apply:
Submit your resume and cover letter through our online portal.

WPS Health Solutions is an equal opportunity employer.