20 Best Registered Nurse Iii jobs in San Antonio, TX (Hiring Now!)

Medicare Medical Review RN (Medical Reviewer III)
CoventBridge Group —United States
Must have and maintain a valid driver' license for the associate's state of residence as onsite audits are part of the role as a nurse reviewer.
$65,000 - $75,000 a year
4d
Registered Nurse III
Dept of State Health Services —San Antonio, TX
Applicants with an out-of-state driver’s license must provide an original certified driving record from the state of driving licensure.
$7,500 - $8,463 a month
Nurse III
Health & Human Services Comm —San Antonio, TX
Licensed to practice as a registered nurse in the State of Texas (or state that recognizes reciprocity through the Nurse Licensure Compact).
$7,532.75 - $8,463.00 a month
Utilization Management Nurse III - Case Management
Christus Health —San Antonio, TX
This Nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and…
Estimated: $86.9K - $110K a year
10d
Registered Nurse III (RN) CVICU - Days/Nights-San Antonio TX- Salary to $84k/yr!
Prominent Career Solutions, LLC —San Antonio, TX
Consistently applying the nursing process, critical thinking skills, scientific judgment, technical skills and leadership to independently deliver safe nursing…
$84,000 a year
Quick Apply
Staff Nurse III - NBS
University Health —San Antonio, TX
Current Registered Nurse licensure from the Board of Nurse Examiners of the State of Texas is required. Assumes the responsibilities of leadership in designated…
RN III ICU Day Shift Part-Time
UT Health Science Center at San Antonio —San Antonio, TX
The Registered Nurse (RN) III position is a licensed staff nurse, who as an advanced clinician, and functions at the Proficient level.
3d
Nurse III - ICF/IID
Health & Human Services Comm —San Antonio, TX
If you are an active or former licensed nursing facility administrator, certified nurse aide, or medication aide, hiring will be pending until professional…
$7,118.31 - $8,463.00 a month
14d
Registered Nurse II/ III (RN) Surgical ICU - Days-San Antonio TX-Salary to $84k/yr!
Prominent Career Solutions, LLC —San Antonio, TX
Consistently applying the nursing process, critical thinking skills, scientific judgment, technical skills and leadership to independently deliver safe nursing…
$60,000 - $84,000 a year
Quick Apply
Registered Nurse III (RN) CVICU - Days/Nights
Steneral Consulting —San Antonio, TX
Consistently applying the nursing process, critical thinking skills, scientific judgment, technical skills and leadership to independently deliver safe nursing…
$58,000 - $80,000 a year
Quick Apply
Staff Nurse III
University Health —San Antonio, TX
Current RN license from the Texas Board of Nursing. Comprehensive benefits package including pet insurance.
3d
RN III Advanced Care Clinic Day Shift Full Time
UT Health Science Center at San Antonio —San Antonio, TX
The Registered Nurse (RN) III position is a licensed staff nurse, who as an advanced clinician, and functions at the Proficient level.
4d
Nurse Educator III - Simulation Program
University Health —San Antonio, TX
Demonstration of experience in curriculum development and implementation of adult learning principles is required. MSN is required, PhD is preferred.
RN III ICU Day Shift Full Time
UT Health Science Center at San Antonio —San Antonio, TX
The Registered Nurse (RN) III position is a licensed staff nurse, who as an advanced clinician, and functions at the Proficient level.
3d
RN III- Medical Oncology
UT Health Science Center at San Antonio —San Antonio, TX
Current Texas Board of Nursing (or Compact State) RN license required or temporary TX License (Permanent license to be obtained within 90 days of hire).
Registered RN III Surgical ICU (Days/Nights) San Antonio TX-Salary to $78k/yr
Prominent Career Solutions, LLC —San Antonio, TX
Instruct and educate patients and families. Graduate of an accredited diploma, associates, or baccalaureate degree nursing program.
$78,000 a year
Quick Apply
RN III Advanced Care Clinic Day Shift Part-Time
UT Health Science Center at San Antonio —San Antonio, TX
The Registered Nurse (RN) III position is a licensed staff nurse, who as an advanced clinician, and functions at the Proficient level.
4d
Nurse III-On-Duty RN (ODRN)
Health & Human Services Comm —San Antonio, TX
Performs technical nursing procedures according to facility and state regulations after demonstration for competency, i.e., tracheostomy care, gastrostomy…
$7,532.75 - $8,463.00 a month
RN III Advanced Care Clinic Night Shift Full Time
UT Health Science Center at San Antonio —San Antonio, TX
The Registered Nurse (RN) III position is a licensed staff nurse, who as an advanced clinician, and functions at the Proficient level.
4d
Nurse III - Health Fac
Health & Human Services Comm —San Antonio, TX
Under the direction of a program manager, a nurse III conducts on-site licensure inspections, complaint and incident investigations, and annual comprehensive…
$7,118.31 - $8,463.00 a month

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Medicare Medical Review RN (Medical Reviewer III)

CoventBridge Group - United States

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Job Details

Full-time $65,000 - $75,000 a year 4 days ago

Benefits

Disability insurance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance
401(k) matching

Qualifications

Microsoft Word
Microsoft Excel
Medicare
RN License
ICD-9
ICD-10
Analysis skills
Driver's License
Medical records
Bachelor of Science in Nursing
CPT coding
Leadership
Medical terminology
2 years
Communication skills
DRG

Full Job Description

Overview:

Medicare Medical Review RN (Medical Reviewer III) - REMOTE

The Medicare Medical Review RN (Medical Reviewer III) will primarily be responsible for conducting clinical reviews of medical records during the course of fraud investigations or other program integrity initiatives such as requests for information or in support of proactive data analysis efforts. In addition, this position applies Medicare and Medicaid guidelines in making clinical determinations as to the appropriateness of payment coverage.

In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse.

This position will report directly to the Medical Review Supervisor and will work in our Grove City, OH office. If not local, remotely from a home office.

Responsibilities/ Requirements:

Responsibilities:

Reviews information contained in Standard Claims Processing System files (e.g., claims history, provider files) to determine provider billing patterns and to detect potentially fraudulent or abusive billing practices or vulnerabilities in Medicare or Medicaid payment policies
Utilizes extensive knowledge of medical terminology, ICD-9-CM, ICD-10-CM HCPCS Level II and CPT coding along with analysis and processing of Medicare claims. Utilizes Medicare/Medicaid and Contractor guidelines for coverage determinations
Coordinates and compiles the written Investigative Summary Report to the PI Investigator upon completion of the records review
Incorporates leadership and communication skills to work with physicians and other health professionals as well as external regulatory agencies and law enforcement personnel
Provides training to UPIC staff on medical terminology, reading medical records, and policy interpretation
Provides expert witness testimony as required
Completes assignments in a manner that meets or exceeds the quality assurance goal of 98% accuracy
Maintains chain of custody on all documents and follows all confidentiality and security guidelines
Performs other duties as assigned by the Medical Review Supervisor that contribute to UPIC goals and objectives and comply with the Program Integrity Manual and Statement of Work guidelines and CMS directives and regulations

Requirements:

2 years minimum experience at a government contractor (ZPIC, UPIC, RAC, MAC, etc.)
2 years minimum working knowledge of ICS 10-CM/CPT coding experience
4 years minimum experience of working knowledge of Diagnosis Related Groups (DRG's), Prospective Payment Systems or Part B claims and Medicare coverage guidelines
Knowledge of, and the ability to correctly identify, Medicare and Medicaid coverage guidelines
Advance knowledge of medical terminology and experience in the analysis and processing of Medicare claims, utilization review/ quality assurance procedures, ICD 10-CM and CPT coding, Medicare coverage guidelines and payment methodologies (i.e., Correct Coding Initiative, DRG's, Prospective Payment Systems and Ambulatory Surgical center), NCPCP and other types of prescription drug claims
Ability to read Medicare claims, both paper and electronic, and a basic knowledge of the Medicare claims systems is required
Should possess excellent oral and written communication skills with an ability to write professional summary reports
Knowledge of and ability to use Microsoft Word, Excel, and Internet applications
Able to efficiently organize and manage workload and assignments
Must have and maintain a valid driver' license for the associate's state of residence as onsite audits are part of the role as a nurse reviewer

Educational/Experience Qualifications:

Graduate from an accredited school of nursing and have an active license as a Registered Nurse (RN) required
Preference given to BSN or higher prepared nurses with recent medical review claims experience in Medicare or Medicaid reviews

Benefits:

Medical, Dental, Vision plans
Life, LTD and STD paid by the employer
401(k) with company match up to 4%
Paid Time Off and company paid holidays
Tuition assistance after 1 year of service

The salary range for this role is $65,000 to $75,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

About Us:

CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.

CoventBridge is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.

CoventBridge is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.

Apply Now

Registered Nurse Iii jobs in San Antonio, TX

Medicare Medical Review RN (Medical Reviewer III)

Registered Nurse III

Nurse III

Utilization Management Nurse III - Case Management

Registered Nurse III (RN) CVICU - Days/Nights-San Antonio TX- Salary to $84k/yr!

Staff Nurse III - NBS

RN III ICU Day Shift Part-Time

Nurse III - ICF/IID

Registered Nurse II/ III (RN) Surgical ICU - Days-San Antonio TX-Salary to $84k/yr!

Registered Nurse III (RN) CVICU - Days/Nights

Staff Nurse III

RN III Advanced Care Clinic Day Shift Full Time

Nurse Educator III - Simulation Program

RN III ICU Day Shift Full Time

RN III- Medical Oncology

Registered RN III Surgical ICU (Days/Nights) San Antonio TX-Salary to $78k/yr

RN III Advanced Care Clinic Day Shift Part-Time

Nurse III-On-Duty RN (ODRN)

RN III Advanced Care Clinic Night Shift Full Time

Nurse III - Health Fac

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