Medical Review Nurse

Getting Results.  Making a Difference.

 

IntegriGuard relies on the highest caliber employees to achieve results for our clients.  The experience, dedication, and innovative thinking of our staff is integral to our position as a national leader in the field of detection and deterrence of improper payments, fraud, and waste.

 

Our employees get results.

 

Our work makes a difference.

 

Our corporate culture makes IntegriGuard a great place to work.

 

We currently have openings for:

 

Medical Review Nurses – RN’s & LPN’s

 

IntegriGuard has new opportunities for Medical Review Nurses to utilize their skills protecting the Medicare trust fund.  The successful individual will perform a clinical review of medical records and/or other documentation to determine the accuracy and appropriateness of billings for provided services; complete medical review summaries to document findings; maintain internal quality control processes to assure the reliability of project reviews; provide support to internal and external customers with respect to clinical and  Medicare-related issues; conduct claims research using the appropriate systems; attend on-site visits with investigative team as necessary to retrieve medical records and conduct provider interviews; research policy, regulations, and coverage determinations; and provide a clinical perspective to investigative team during fraud case development.

 

Position requirements include:Active RN or LPN license in good standing Bachelor’s degree in nursing or related field preferred Minimum of three years diversified nursing experience providing direct care in an inpatient or outpatient setting One or more years experience performing medical records review or utilization review preferred Knowledge of the Medicare program preferred, particularly the coverage and payment rules Ability to maintain high quality work while meeting strict deadlines Excellent written and verbal communication skills Not currently sanctioned or excluded from the Medicare program by the OIG

Send resumes to humanresources@integriguard.org or fax to 402.498.2544

 

www.integriguard.org

 

EOE/Affirmative Action Employer