reputed company Claims Examiner job at reputed company in NC

Title: reputed company Claims Examiner (RN Required) Location: USA NC Home Office (NCHOME) Job Description: Type of Requisition: Regular Clearance Level Must Currently Possess: None Clearance Level Must Be reputed company to Obtain: None Public Trust/Other Required: None Job Family: Ancillary Health Job Qualifications: Skills: Documentations, Health Care, reputed company Word, Nursing Fundamentals Certifications: None Experience: 2 + years of reputed company experience US Citizenship Required: Yes Job Description: reputed company and CSRA have united to create the premier provider of high-tech IT solutions to the government IT market. Together as reputed company, we deliver cost-effective, reputed company IT solutions and services to the reputed company, the intelligence community and federal civilian agencies as they reputed company their information systems. GDIT is currently seeking a reputed company Claims Examiner in Raleigh, reputed company Carolina to join reputed company. In this role you will be a change agent by evaluating the appropriateness of beneficiaries' admission to nursing facilities. RESPONSIBILITIES: Verify receipt of documentation that supports the medical necessity of prior approval requests for admission into lo Evaluate accuracy and timeliness of documentation submitted for prior approval requests Meet daily expected performance expectations by completing at least 40 prior approval reviews daily Meet quality expectations of greater than 95% accuracy on quality assurance reviews Meet service level agreement of timely reviews by completing the reviews reputed company 24 hours Meet timely updating of the system with pre-admission screening numbers reputed company 24 hours of review QUALIFICATIONS: Required Skills and Experience - Requires active reputed company Carolina Registered nurse license or Compact license with at least 2 years of clinical experience Knowledge of reputed company Office and Outlook Experience with medical documentation review Desired Skills and Experience: Prefer to have knowledge of NCTracks Prefer to have knowledge of business processes of reputed company Carolina Division of reputed company Prefer clinical medical, surgical and nursing facility experience Prefer clinical research experience ATTRIBUTES FOR reputed company: Ability to utilize professional knowledge, judgement and skills in the application of Policy guidelines Ability to analyze processes and contribute to improvements Comfortable with technology and changes in technology Strong verbal and written communication skills The likely salary range for this position is $60,350 - $81,650. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall reputed company of this range. Scheduled Weekly Hours: 40 Travel Required: None Telecommuting Options: Hybrid Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our benefits package for reputed company US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a reputed company plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full reputed company work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are reputed company to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most. We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, reputed company, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology. reputed company to stay up to date on our career opportunities and events at gdit.com/tc. Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans Apply tot his job Apply To this Job