USRN Surgical/OR/Bill Review Nurse

Let your Passion Lead You at the Home of Clinicians with over 6000+ employees who have trusted us with their careers! Our Clinicians & Associates advocates for better patient care while enjoying these benefits: Hybrid Work Setup (Onsite training; performance based WFH after ramp)

Competitive Compensation Package

HMO on Day 1 with 2 dependents upon regularization

Group Life Insurance

Complexity Allowance

Annual Salary Increase

Quarterly Performance Bonus

Service Incentive Leave (SIL) with Leave Conversion

Work-Life Integration

Visa Sponsorship & Work Abroad through our Nurse Compass Program*Earn up to $12,000 in program bonuses, including:$1,000 upon I-140 filing$1,500 annual milestones$5,000 five-year loyalty bonus$3,000 U.S. arrival bonus

Build your U.S. nursing career with Shearwater Health. Terms and conditions apply.

Job Summary

The USRN Surgical/OR/Medical Bill Review Nurse role is responsible in performing medical necessity review of proposed prospective, concurrent, and retrospective cases such as medical treatments, auto-injury related request, hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiently in accordance with the client's-specific contract rules and guidelines and with company's policies, practices and procedures to facilitate quality and cost effective care for the injured employee. Qualifications: Must have an active US Nursing License; Mainland License

• With at least two (2) years of recent OR/Surgical experience in a hospital setting required
• Preferably (2) years of experience in daily application of nurse auditing, utilization review and bill review, but not required
• Preferably with prior experience in PPO provider appeals, re-pricing, surgery review, by report and RNE review
• Preferably with experience in utilization of Strataware, but not required

Note: Kindly ensure to complete the pre-screening questions and upload your resume to proceed in the next stage of the recruitment process.