Mitchell International, inc.

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3rd Party Medical Nurse Reviewer (full-time)

at Mitchell International, inc.

Posted: 7/27/2019
Job Status: Full Time
Job Reference #: 9189

Job Description

  • Job LocationUS-CA-San Diego
    Job ID
    19-9189
    Type
    Regular Hire
  • Company Overview

    Mitchell is a trusted software and service provider to the Property & Casualty Claims and collision repair industries as well as risk management professionals. We provide technology and services that simplify claims handling, repair processes and pharmacy transactions with best in class clinical management and cost containment solutions. Our recent merger with Genex brings together two industry leaders in software and service committed to delivering a first-class experience to the customers, partners and markets we serve. We offer a complete suite of technology enabled solutions, and a proven managed care service mix, allowing us to deliver better outcomes to our clients for their businesses, their employees and their customers.

    Job Description

    ACS (third party)

    As a Medical Nurse Reviewer with Mitchell you will read complete medical claim files and construct a summarization and analysis of the treatment rendered to the injured party. You will communicate with claims adjusters and bill review team members to ensure adequate application of any appropriate guidelines and review decisions. You will apply nursing knowledge, utilize medical review criteria and solid clinical judgment to ensure treatment approved is medically necessary. You will also act as a point of contact for escalated customer concerns.

    Qualifications

    ACS (third party)

    • Knowledge: You are a seasoned, experienced professional with a full understanding of auto casualty business. You will work one case at a time with approximately 25-30 cases a month. A clinical background related to trauma, orthopedic, physical and rehabilitation nursing is a plus.
    • Experience: Mitchell’s Nurse Reviewers are Registered Nurses and will typically have at least 3 years clinical experience and one year reviewing experience
    • Must be able to work independently, but also work well within a team setting to achieve the highest quality results and outstanding customer service.
    • Well-developed communication, verbal and written, plus strong interpersonal skills are required.
    • Must be computer proficient with hardwired home office station.
    • Written Abilities: Proficient grammar, sentence structure and written communication skills required.
    • Licenses or Certifications: You must be a registered nurse (RN). Having certifications within Legal Nurse Consulting and CPC are a plus.

    *Requires DSL, fiber or cable internet connection from home. 1 mbps preferred or better.*

    Mitchell International, an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. Mitchell will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.

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