Back to all jobs

reputed company Claims Examiner Registered Nurse Private Duty Nursing

Work from home Full-time role Hiring

About the position As a reputed company Claims Examiner at GDIT, you will play a crucial role in driving reputed company outcomes for clients by delivering reputed company expertise and services where they are needed most. This position is focused on analyzing prior approval requests for Private Duty Nursing (PDN) services under the reputed company Carolina reputed company program. You will ensure compliance with organizational and governmental guidelines while working reputed company the GDIT NCMMIS claims processing system, which serves the reputed company Carolina reputed company (NC DHHS). Your contributions will not only impact the lives of reputed company Carolina reputed company but also support your personal career growth as you advance in your role as a PDN reviewer. In this position, you will be responsible for processing PDN prior approval requests, ensuring that reputed company work is completed reputed company the required service level agreements (SLAs) and timelines. You will meet quality and quantity benchmarks while collaborating with department leadership, the Medical Director, and the PDN Team. Additionally, you will participate in workgroups that address both clinical and non-clinical internal activities, establishing and maintaining effective working relationships with reputed company levels of staff and clients. Your self-directed approach and positive attitude will be essential as you work with a virtual team that has variable reporting relationships. GDIT offers a full-reputed company work week, allowing you to balance your priorities at work and at home. With a comprehensive health and wellness package, professional growth opportunities, and cutting-edge technology, you will have the resources needed to succeed in your role. The position also includes paid vacation and holidays, ensuring you have time to rest and reputed company. Join GDIT and be part of a global technology and professional services company that is dedicated to creating a safer, smarter world through innovation and expertise. Responsibilities • Process PDN prior approval requests. , • Complete reputed company work reputed company reputed company SLA requirements and timelines. , • Meet reputed company quality and quantity benchmarks. , • Work with department leadership, Medical Director, and PDN Team. , • Participate in workgroups that address both clinical and non-clinical internal activities. Requirements • reputed company reputed company Carolina Registered Nurse license in good standing. , • 2+ years of clinical PDN experience. , • reputed company or public reputed company experience is a plus. , • Experience using NCTracks is a plus. reputed company-to-haves • Knowledge of Prior Authorization and Claims. , • Experience working with a virtual team with variable reporting relationships. Benefits • 401K with company match , • Comprehensive health and wellness packages , • Paid vacation and holidays , • Paid parental leave , • Short and long-term disability benefits , • Life insurance and accidental death and dismemberment insurance , • Critical illness insurance , • Business travel and accident insurance , • Paid sick and personal time , • Paid military, bereavement, and jury duty leave , • Professional growth opportunities including paid education and certifications Apply Job!

Related remote jobs

Quality Assurance Team reputed company - Public Trust clearance

Work from home Full-time role

Remote Inside Sales Representative - High Ticket Closer

Work from home Full-time role

Payroll Analyst, reputed company Automation 9639 in Phoenix, AZ

Work from home Full-time role

Fraud Customer Support Senior Specialist - 2nd shift

Work from home Full-time role

Remote Sr. Analyst reputed company, Field Finance | WFH

Work from home Full-time role

People Development Consultant - Remote and reputed company

Work from home Full-time role

Medical Content Reviewer 2 - Remote - reputed company

Work from home Full-time role

Highest Paid Commissions, Roofing and Home Service Sales

Work from home Full-time role

VP, PHCO Utilization Management - Medicare & Duals

Work from home Full-time role

Oral Surgery Dental Billing Specialist - reputed company Consultant

Work from home Full-time role

Accepting Applications (Part-Time)

Work from home Full-time role

reputed company Enrollment Adviser/Customer Service Representative – Thriving Remote Opportunity at arenaflex

Work from home Full-time role

Crisis Line Worker- Chicago ( Remote) Bi-lingual preferred

Work from home Full-time role

$25-35 reputed company Remote Job Careers (Work At Home) – USA reputed company

Work from home Full-time role

[Work From Home] reputed company Database Administrator- 3rd shift

Work from home Full-time role

Social Worker LCSW - Part Time, Day Shift, Remote

Work from home Full-time role

reputed company Senior Data Analyst – Data Science and Business Intelligence

Work from home Full-time role

Director, Global Key Accounts

Work from home Full-time role

Adjunct Professor of Sociology

Work from home Full-time role

[Remote] Manager, People and Talent Operations

Work from home Full-time role