Performant Corp

Medical Review Nurse - Home Health Auditor

Performant Corp · Full Time · 2 months ago

Performant Corp

🌎 United States 💵 $78500 - $90000 per year ⭐ 5-10 yrs exp 💼 Finance

Perform medical claims audit reviews on Home Health claims for government and commercial payers. Document findings, generate audit letters, and collaborate with teams to improve medical policies and provider education.

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Medical Review Nurse - CMS RAC (Government audits)

Performant Corp · Full Time · 2 months ago

Performant Corp

🌎 United States 💵 $81000 - $90000 per year ⭐ 5-10 yrs exp 💼 Healthcare

Perform medical claims audit reviews for government and commercial payers to ensure services are medically appropriate. Document findings, generate audit letters, and support findings during the appeals process.

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Quality Assurance Supervisor (Clinical RN)

Performant Corp · Full Time · 2 months ago

Performant Corp

🌎 United States 💵 $95000 - $105K per year ⭐ 5-10 yrs exp 💼 Software Development

The Quality Assurance Supervisor manages a remote team of nurses and auditors, overseeing clinical review audits and ensuring productivity and quality standards are met. They also contribute to strategy, resource planning, and the development of medical review guidelines to improve operational outcomes.

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Medical Review Clinical Appeals Auditor (RN)

Performant Corp · Full Time · 3 months ago

Performant Corp

🌎 United States 💵 $80000 - $90000 per year ⭐ 5-10 yrs exp 💼 Finance

The Medical Review Clinical Appeals Auditor (RN) conducts Appeals reviews of new evidence presented by auditees and documents Appeals results according to quality policies. They also contribute to continuous improvement initiatives and may support training activities for new or existing staff.

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Medical Review Nurse II - SNF/MDS

Performant Corp · Full Time · 3 months ago

Performant Corp

🌎 United States 💵 $84000 - $100K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Medical Review Nurse II primarily performs medical claims audit reviews, conducting retrospective and prepayment audits for Government and Commercial Payers based on appropriate medical review guidelines. Responsibilities include documenting findings, generating articulation letters, supporting audits during appeals, and collaborating on policy and system improvements.

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HCS Customer Service Specialist II (SCA)

Performant Corp · Full Time · 3 months ago

Performant Corp

🌎 United States ⭐ 0-2 yrs exp 💼 Support

The specialist serves as the primary contact for Medicare contractors and providers, delivering professional, accurate, and timely responses to inquiries via written, telephonic, and electronic means. Key duties involve maintaining knowledge of contract requirements, resolving complex issues via inbound calls, and conducting necessary research and follow-ups.

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HCS Operations Inventory & Quality Analyst (Eligibility)

Performant Corp · Full Time · 3 months ago

Performant Corp

🌎 United States 💵 $61300 - $73000 per year ⭐ 2-5 yrs exp 💼 Others

This role supports inventory management, process documentation, and production quality assurance for Eligibility operations teams by ensuring accurate inventory distribution and conducting compliance audits against internal, client, and regulatory requirements. The analyst will utilize SQL and subject matter expertise to test data flow, perform audits, create metrics reporting, and mentor operations and data teams on processes.

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Medical Coding Auditor - Inpatient (OIG Focus) Clearance required

Performant Corp · Full Time · 6 months ago

Performant Corp

🌎 United States 💵 $70000 - $85000 per year ⭐ 5-10 yrs exp 💼 Finance

The Medical Coding Auditor is responsible for auditing medical records and ensuring compliance with coding guidelines. This role involves identifying errors, providing feedback, and collaborating with coding staff to improve accuracy.

insurance medical-coding medical communication training organization talent-acquisition compliance human-resources

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