Nurse Consultant - NCLEX RN

Nurse Consultant - NCLEX RN Industry: BPO (Healthcare) Location: Infopark, Kakkanad, Kochi Qualification: BSC Nursing/ Post BSC Requirement: Valid NCLEX-RN Certification(Manadatory) Shift: 6PM to 3AM (Monday-Friday) Salary: Upto Rs.12 LPA - Rs.18 LPA 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 appeals, grievances, pre-authorizations, and utilization review cases accurately and within defined timelines. Requirements Qualification: Bachelor of Science in Nursing (B.Sc Nursing) / Post Basic B.Sc Nursing Valid NCLEX-RN Certification(Manadatory) Excellent verbal and written English communication skills Willingness to...