Nurse Consultant - NCLEX RN

Nurse Consultant - NCLEX RN

Industry: BPO (Healthcare)

Location:  Infopark, Kakkanad, Kochi Qualification: BSC Nursing/ Post BSC (GNM not considered) Requirement: Valid NCLEX-RN Certification(Manadatory)

Shift:  6PM to 3AM (Monday-Friday)

Salary: 40 ,000/- to 60,000/- (CTC) Per Month

Should have excellent fluency in English.
Responsibilities

• Review and analyze medical claims, provider appeals, and dispute cases within the US healthcare insurance process.
  
• Evaluate clinical documentation, medical records, and supporting evidence to determine medical necessity and appropriateness of care.
  
• Assess healthcare claims using clinical guidelines, payer policies, and utilization management criteria.
  
• Process appeal...