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Medical Review Nurse
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Information Technology company
Contract
Information Technology company
Miami, FL ( Map it )
No permanent US residency required
W-2 only
Miami, FL
Contract
This posting is no longer accepting new applicants

Requirements: 
• Active Florida Nursing License with two (2) years of related work experience
• Must have previous medical record / quality review experience; HEDIS/STARS preferred
• Must be proficient in Microsoft Office (Word, Excel, Outlook, and PowerPoint) as well as Internet research skills
• Ability to communicate clearly verbally and in writing 
• Organizational skills are very important; must be able to work independently to complete tasks with minimal direction. 

Preferred:
• Disease management experience is helpful
• Recent experience in medical record reviews, data collection for HEDIS / Stars 

Job Description: 
• Perform medical record reviews to support improvement and compliance, abstract HEDIS data, to include over-read of reviews, working collaboratively with internal HEDIS STARs Team and the Quality Team.
• Perform administrative functions to include; medical record request, faxing and calls to members and providers as needed. Maintain organized, updated reporting of activities with clear documentation. Required to track, monitor and report on the status of records and volume of work.
• Complete claim research to identify the service performed, dates of service, provider type, and place of service. Research may include multiple systems and reports.

Skills
Skill Proficiency Years Experience Percent Used
Nursing
1 - 3100%
EHR
Any75%
HEDIS
1 - 375%
Medical Claims
Any75%
Microsoft Office
Any75%
EMR
Any50%
Compliance
Any25%
Documentation
Any25%
Microsoft Excel
Any25%
Position Recruiter
Luda Melanich
luda@cloudteam.com
813-868-3833