Working Nurse

Payment Integrity Nurse Coder RN III (Job ID: 12330) Location: Los Angeles, 90017 Shift: Full Time Pay Range: $102,183.00 (Min.) – $132,838.00 (Mid.) – $163,492.00 (Max.) Job Description The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise and judgment in the application of medical and reimbursement policies within the claim adjudication process. The role involves medical record review for Payment Integrity and Utilization Management projects, serving as a subject‑matter expert (SME), performing quality audits, validating coding accuracy and completeness, and guiding Payment Integrity initiatives, including concept and cost avoidance development. Additionally, the position trains and mentors Payment Integrity Nurse Coder, RN staff, acting as a resource and mentor for fellow employees. Qualifications At least 8 years of clinical RN experience. At least 3 years of experience in utilization...

A prominent healthcare institution in Los Angeles is seeking a Payment Integrity Nurse Coder RN III to review medical records and provide expertise in claim adjudication. The role requires extensive knowledge of coding and healthcare reimbursement. Ideal candidates will have substantial RN experience in clinical settings and a strong background in utilization management or clinical coding. This position offers a full-time shift and great compensation along with the opportunity to mentor other staff members. #J-18808-Ljbffr