Contract Registered Nurse (RN), Utilization Review (Behavioral Health) - 221556
📋 Role Overview & Responsibilities
- *Please ensure that you meet the listed job requirements before applying.**
Location: RemoteDuration: CONTRACT, expected end date is October 2024Schedule: Monday-Friday, 8am-5pm (40-hour work week expected, may slightly vary some weeks due to business needs)Pay Rate: $35-42/hour (depending on experience)Equipment Provided: Laptop, monitors, and cell phonePre-employment Requirements (if hired): Background check (BG), drug screen (DS), education (EDU), and employment verification (EMP)
Job Responsibilities: This role focuses on reviewing Arizona Medicaid claims for accuracy, both before and after service delivery, ensuring correct billing and coding. It addresses issues with incorrectly billed Behavioral Health services for AHCCCS patients identified last year. Duties include pre-certifying Subacute Detox Admissions, assessing outpatient Behavioral Health claims
Job Requirements:Active COMPACT Registered Nurse (RN) license.At least one (1) year working in a Utilization Review position.At least one (1) year of nursing experience working in either/or a: Behavioral Health/Psych Unit, Mental Health or Detox facility, or a related mental health facility. OP BH Claims Review (post-service and pre-payment) specifically.Working knowledge of OP BH HCPCs codes (e.g., H0004, H2017, S9480, etc.).Microsoft Teams proficiency.SharePoint familiarity.
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