Registered Nurse

Job Title: Registered NurseLocation: Aguadilla, Puerto RicoJob Type: Full Time ( Onsite)In this role, you will be responsible for accurate and timely processing of healthcare claim service request and processing of claims using your medical knowledge to process according to a workflow that requires the review and evaluation of the service request as per SOP.Job responsibilities: Responsible for accurate and timely processing of healthcare claim service request and processing claimsReviews, evaluates the service request as per SOPFamiliar with Medical Policy, Familiar with Clinical service requests, correspondence inquiries and image reviewForward the cases to appropriate teams, post the in-scope activities have been completed as per SOP (Standard operating Procedure)Prep medical records for clinical reviewEnd to end processing and resolution of clinical claims and correspondenceUnderstand/interpret medical terminology including clinical notes and reportsAble to review medical policies ...