Medical Review Nurse

The primary business of First Coast Service Options, Inc., is administering programs that serve Medicare beneficiaries. We focus on customer service, continuous improvement, and compliance. Our employees are committed to living by the values: The right things, the right way.

 

Job duties include, but are not limited to:

•Make medical review claims adjudication decisions.
•Review provider practices and identify issues of concern, overpayment and need for corrective action.
•Develop recommendations for further corrective action based on medical review findings.
•Implement corrective action related to medical review activities.


Job Requirements:

 Registered Nurse, licensed in the State of Florida
* 3 years clinical experience
* 2 years related Managed Care and/or Medicare experience
* Proficiency using MS Word and MS Excel
* Strong written and verbal skills


Business Specific Criteria (preferred skills):
-Bachelors of Science Degree in Nursing
-Experience using MCS a plus
-Experience working with Medicare regulations (Part B).
-Experience working with CPT-4 coding and ICD-9.
-Bilingual (Spanish)


 

Please visit our website at www.fcso.com and click on WHO WE ARE to apply.