Clinical Documentation Review Nurse

📋 Description

• Assess patient charts and documentation against established coverage criteria

• Utilize internal AI software designed to enhance review efficiency

• Implement structured processes to evaluate documentation adequacy

• Detect and flag any missing or inconsistent documentation

• Generate clear, standardized written summaries of review results

• Achieve daily throughput and quality objectives (e.g., reviews per day, QA pass rates)

• Integrate feedback from QA to consistently enhance accuracy and efficiency

• Partner with the product team to improve software over time

⛳️ Requirements

• Valid RN license (BSN preferred but not mandatory)

• Minimum of 2 years clinical experience or previous utilization review/documentation review experience

• Exceptional attention to detail

• Quick learner of new concepts

• Ability to adhere to structured workflows and consistently apply rules

• Comfortable in a high-throughput, metrics-oriented environment

• Excellent written communication skills

• Experience with DME, Medicare regulations, or surgical dressing reviews is preferred but not required

🏝️ Benefits

• We cover 100% of your health insurance premium and offer access to high-quality dental and vision insurance plans for you and your dependents.

• We provide a 401(k) plan to assist you in saving for your future. Currently, the company does not offer a 401(k) match.

• You'll have opportunities for rapid career advancement in a company that's experiencing significant growth. We want you to develop alongside us.