QA RN(s) -Boston Area in Boston, MA

Position detailsExciting Opportunities exist for QA/RN's at 1 of the state's premier agencies. Responsible for reviewing clinical records to ensure compliance with agency policy, reimbursement qualifications, maximization of utilization (both frequency and disciplines) and quality clinical standards of practice.Conducts continuous utilization review of clinical records on a weekly basis to prepare for branch bi-weekly Medicare bills.Participates in agency wide quality improvement activities including developing, implementing and maintaining educational training programs. Desired Skills & BackgroundQualifications Knowledge of Medicare Program, coverage qualifications and payment provisions (PPS & FFS)Knowledge of Medicare appeals process and other health program funing/insurance eligibility.Knowledge of principles of utilization management.Background with OASIS a plusPlease send resume directly to XXX@XXXX or call Ross Cooper at [removed phone]Listing originally posted at http