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Clinical Reviewer - Nurse or Social Worker
CHCS Services India Pvt. Ltd.
posted 4mon ago
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Fixed timing
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Job Description
- The Assessment Team Clinical Nurse Reviewer is responsible for the timely and accurate review of completed cognitive and functional assessments conducted for Long-Term Care Insurance policyholders
- Assessments included are on-site, video, telephonic recertification and telephonic for private caregivers
- Interacting with assessors, the Clinical Nurse Reviewer obtains necessary clarifications to documentation submitted, provide training to assessors who are new or need retraining on completing assessments and conducts telephonic assessments with other health care providers when an assessment/reassessment is needed for a claimant residing in a long-term care facility
- The Clinical Nurse Reviewer reviews clinical questions from long term care insurers
- The Clinical Nurse Reviewer documents and provides input on the quality of assessors upon completing their review
Essential Job Functions
Reviewing completed assessment documents
- Following up with nurse assessors to correct or clarify results where needed.
- Providing training for nurse assessors to ensure a quality assessment is performed.
- Completing telephonic assessments of claimants and caregivers when necessary.
- The essential job functions listed above are not all encompassing. Other duties and responsibilities may be required.
Performance Expectations:
- Communicate with both internal and external resources with professionalism.
- Complete assessments reviews in a timely manner ensuring accurate information in each assessment before submission to Long Term Care Insurance companies.
Required Skills/Abilities:
- Show initiative and good nursing judgment.
- Typing skills 45 wpm
- Knowledge of Windows, Microsoft Suite and Adobe Editor
- Exhibit excellent customer service skills.
- Work on multiple tasks at any one time while maintaining high quality standards.
- Must be process-oriented with sound judgement, attention to detail, accuracy, and follow-through including the flexibility to perform in an ever-changing work environment.
- Must have hi speed internet of at least 80 mbps per minute.
- Enclosed room within your home, for a quiet and HIPAA compliant work environment.
Required Education and Experience:
- High school diploma or GED
- An unencumbered Registered Nurse in the state of residence. Verification of certificate from an approved school of Nursing.
- Six months to one-year previous related experience in a healthcare environment specifically working with elderly, geriatrics, memory care community or the like preferred.
- Alzheimer s certification, clinical case management and/or assisted living experience preferred.
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer.
Employment Type: Full Time, Permanent
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based on 62 employees
Strict timing
Monday to Friday
No travel
Night Shift
CHCS Services India Pvt. Ltd. Benefits
Health Insurance 
Work From Home 
Job Training 
Soft Skill Training 
Free Transport 
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