Registered Nurse-Quality Assurance
FEFA LLC, United States
Job Description
FEFA LLC is seeking a skilled RN professional to manage and evaluate patient health information within our exclusive electronic medical record system. This role involves analyzing various medical and specialty examination documents to determine outcomes and ensure compliance with regulatory and contractual standards. By conducting thorough clinical reviews and corroborating information through phone interviews with Service Members and Veterans, you will produce clear, comprehensive, and concise reports. Your responsibilities will include identifying and addressing quality assurance issues, collaborating with providers and patients via our nurse call line, and promptly addressing emergent behavioral health concerns.
Key Responsibilities:
- Utilize our proprietary electronic medical record system to evaluate and process patient health information for different types of medical and specialty exams.
- Conduct comprehensive clinical reviews of examination documentation, test results, and assessments, ensuring accuracy and compliance with regulatory standards.
- Collaborate with providers, Veterans, and Service Members via the nurse call line to ensure examinations meet regulatory and contractual requirements for compensation and benefit rating purposes.
- Identify and address emergent behavioral health issues, initiating intervention when necessary.
- Remain up-to-date with contract requirements and ensure exam documentation reflects patient service level conditions accurately.
Additional Duties:
- Interpret and document diagnostic test results.
- Educate and support providers, Veterans, and Service Members in navigating medical history information and prior disability claims during appointment paperwork completion.
- Provide exemplary service to providers by addressing appointment-related questions and concerns.
- Complete system-generated tasks to process exam documentation.
- Interface via telephone and email with contracted providers, Veterans, and Service Members to retrieve required Disability Benefits Questionnaire information and provide education regarding contractual protocol.
Requirements
- Accredited Associate’s Degree in Nursing (ADN) or Bachelor’s Degree in Nursing (BSN).
- Current RN license in your state of residency.
- 2+ years of experience in a clinical environment as a Registered Nurse.
- Experience working with an Electronic Medical Record system.
- Understanding of regulatory standards and their application to various examinations and documents.
- Proficiency in Microsoft Office programs and database experience.
- Availability to work MTWRF from either 8:00 am to 5:00 pm CT or 10:00 am to 7:00 pm CT.
- Distraction-free, dedicated home office space, including arrangements for child or dependent care.
- Access to high-speed internet (cable, fiber optic).
Preferred:
- Typing speed of 40 words per minute.
- Experience navigating Microsoft Teams.
- Experience in Home Health or Hospice care.
- Experience reviewing medical disability claims.
- Knowledge or experience in clinical quality assurance, auditing, compliance, education of clinical staff, clinical documentation improvement, and working with Veterans.
- Military experience.
Benefits
FEFA LLC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or on the basis of disability. We offer a competitive compensation package including a competitive salary, medical benefits, PTO, holiday pay and more.