USRN Nurse Trainer

2 days ago

Pasig, National Capital Region, Philippines TASQ Staffing Solutions Full time $104,000 - $130,878 per year
About the job USRN Trainer (Pasig) | Onsite

Work Setup/Shift: WFO / Night shift

Start Date: ASAP

Qualifications:

  • Nursing Graduate (Bachelor's Degree)
  • Active USRN License of any state (but NY is preferred)
  • At least 1-2 years as a Process Trainer
  • Minimum 1-2 years of US Healthcare account experience (Utilization Management Review and Clinical Appeals)
  • Experience with utilization of Interqual/MCG Guidelines
  • Exposure to Inpatient/Concurrent reviews
  • Must be amenable to report in Manila

Responsibilities:

1. Clinical Review & Auditing:

  • Review patient medical records to ensure the accuracy and completeness of documentation.
  • Evaluate and verify the appropriateness of medical codes based on patient diagnoses and procedures.
  • Assist in medical coding audits and provide recommendations for improvements.
  • Collaborate with other healthcare professionals to resolve discrepancies in patient records.

2. Medical Coding Support:

  • Work closely with medical coders to ensure compliance with U.S. healthcare regulations and standards.
  • Provide clinical expertise in the identification of proper coding for procedures and diagnoses.
  • Maintain knowledge of the latest updates to ICD-10, CPT, and other coding guidelines.

3. Quality Assurance & Compliance:

  • Ensure that all healthcare documentation aligns with U.S. healthcare laws, policies, and regulations (HIPAA, CMS).
  • Identify trends or recurring issues related to clinical documentation and coding, and escalate as necessary.
  • Participate in training programs to stay updated on U.S. healthcare regulations and clinical practices.

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