Associate Nurse Technician - Baton Rouge - job 745997

Gainwell Technologies

Date: 05/04/2021

City: Baton Rouge, Louisiana

Employment type: Full-time

Job Description:



POSITION SUMMARY:
Review of claims utilizing records and system reports to determine proper documentation, utilization and appropriateness of services to identify possible fraud, waste and abuse.




ESSENTIAL FUNCTIONS




  • Duties and Responsibilities (List all essential duties and responsibilities in order of importance)


    • Post payment review of claims and records


    • Prepare reports and correspondence


    • Research Policy/Standards with ability to apply to case review

    • Demonstrate an understanding of SURS process; clear communication written and verbal


    • Participate on unit Teams to assist in meeting goals of the unit


    • Meets established production requirements consistently






  • State Plan / Department Specific Duties and Responsibilities (List all essential duties other than those listed above in order of importance)


    • Close assigned cases timely


    • Demonstrate consistent movement of cases towards closure


    • Demonstrate good quality work in conjunction with efficient and effective case movement


    • Demonstrate expanded expertise as experience is gained






  • Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job satisfactorily)


    • Current professional certification/license if applicable


    • Strong analytical skills


    • Coding/Billing experience


    • Record review/audit experience


    • Computer knowledge including Microsoft word and Excel, Office 365


    • Demonstrate self-motivation and ability to work independently


    • Excellent verbal and written communication skills


    • Ability to abide by Gainwell Technologies policies


    • Maintain regular attendance per schedule


    • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

    • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers





QUALIFICATIONS



Required Education:


Bachelor Degree /Associate Degree


Preferred Education:





Required Experience:


At least 2 years’ experience in related field



Preferred Experience:



Knowledge of Medicaid Programs/Billing



Coding experience




Required Licensure/Certification:


Current License if applicable



Preferred Licensure/Certification:



Registered Nurse



Licensed Practical Nurse



Social Worker



Case Manager







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