Medical Claims Reviewer, 6 Month Contract

. Conduct ESRD medical record reviews comparing medical record documentation to EQRS and NHSN to determine accuracy and timely reporting .

Posted 9/25/2026contractRemote • United StatesMid-LevelSenior💰 $31,250 - $32,500 per yearWebsite

Key responsibilities & impact

Conduct ESRD medical record reviews comparing medical record documentation to EQRS and NHSN to determine accuracy and timely reporting
Determine and classify discrepancies based on the type and severity of errors, including missing data, incorrect values, and data entered in the wrong fields
Participate in quality control activities to support corporate and team objectives
Assist with special projects or responsibilities as assigned by management

What you’ll need

Active, unrestricted RN licensure in the United States and in the state of hire OR active compact multistate unrestricted RN license
Associate Degree in Nursing OR graduate of an accredited School of Nursing
Two years of clinical experience plus two years of experience with utilization/medical review, quality assurance or end stage renal disease/dialysis
Strong clinical background in dialysis, managed care, home health, rehabilitation, and/or medical-surgical settings
Knowledge of specific criteria/protocol sets and the ability to use them effectively
Proficiency with word processing software and Microsoft Office
Ability to work independently, prioritize tasks, and make sound decisions
Excellent customer service, communication, organizational, and critical thinking skills
Ability to handle confidential information with discretion
Proficient with computers, including the ability to use multiple screens and programs simultaneously
High-speed internet (non-satellite) and a private, lockable home office
Background check and drug testing prior to start of employment; some positions may require fingerprinting

Comp & perks