Medical Records - Lutz

🏢 Summary: Full-time Billing Specialist role focused on medical claims submission, accounts receivable management, payment collection, and insurance follow-up in a healthcare setting. The position includes handling denied claims, patient billing inquiries, provider credentialing support, and maintaining compliance with healthcare regulations. Candidates should have billing or accounts receivable experience, strong administrative skills, and familiarity with EMR systems and medical terminology. 🗂️ Requirements: High school diploma or AA degree, Accounts Receivable experience, Billing experience, Basic computer skills, Typing speed minimum 45 WPM, Knowledge of EMR systems, Knowledge of clinical and billing terminology, Ability to manage insurance claims and appeals, Knowledge of HIPAA, OSHA, and CLIA regulations, Professional telephone etiquette 📃 Skills: Billing, Coding, EMR, HIPAA, OSHA, CLIA, AccountsReceivable, Credentialing, Typing, Insurance 🏢 Description: Travel Required: No Reports To: Billing Manager and Practice Manager Job Description Responsible for submitting claims and following up with insurance companies, collecting, posting, and managing account payments. Billing experience preferred. Role and Responsibilities Administrative - Prepares and submits clean claims to various insurance companies either electronically or by paper. - Answers questions from patients, clerical staff and insurance companies. - Identifies and resolves patient billing questions and complaints. - Prepares, reviews and sends patient statements. - Evaluates patient's financial status and establishes budget payment plans; follows and reports status of delinquent accounts. - Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor, also prepares information for the collection agency. - Research and appeal denied claims. - Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers. - Works patient and insurance AR. - Helps submit and maintain Provider insurance credentialing. Professional - Demonstrates initiative and responsibility. - Able to perform repetitive tasks without loss of focus. - Adheres to ethical principles. - Time management. - Prioritizes and can perform multiple tasks. - Adapts to change. - Attends all team meetings and mandatory in-service training/education. - Basic computer skills. - Type minimum 45wpm. Communication - Recognizes and respects cultural diversity. - Adapts communication to individual's ability to understand. - Uses professional, pleasant telephone etiquette. - Uses medical terminology appropriately. - Treats all patients and co-workers with compassion, empathy, and mutual respect. - Projects a professional manner and image. - Consistent attendance and punctuality. - Adherence to time clock procedures. Legal - Maintains confidentiality and documents accurately. - Uses appropriate guidelines for releasing patient information. - Practices within the scope of education, training and personal capabilities. - Conducts self in accordance with the employee manual. - Maintains awareness of federal and state health care legislation and regulations; OSHA, HIPAA, and CLIA. Core Competencies - Efficiency. - Attention to details. - Organized. - Punctual. - Takes initiative, proactive. - Team player. - Honesty/Integrity. - Flexible. - Calm under pressure. - Persistence. - Problem solver. - Strategic thinking. - Creativity. - Analytical skills. - Clear and concise communication/listening skills. - Quick learner. - Follow through on commitments. - Enthusiastic, friendly, positive attitude. - Openness to advice and constructive criticism. - Strong work ethic. Physical Demands - Prolonged sitting/walking. - Repetitive motion of head, neck, hands, wrists and arms. - Use of telephone, headset and office equipment such as computers, faxes, scanner copiers. - Multitask position. - Lifting up to 25 lbs. - Extensive reading and writing/typing. Qualifications and Education Requirements - High school diploma, AA degree or higher. - Accounts Receivable and Billing experience preferred. - Billing and coding certification a plus. - Knowledgeable in computer programs, EMR systems, and clinical and billing terminology preferred. - Dermatology experience a plus.

🏢 Summary: Temporary remote medical claims processor role supporting the World Trade Center Health Program through November, with potential follow-on work. The position focuses on reviewing, adjudicating, and processing complex medical claims while ensuring compliance with healthcare regulations and program policies. Candidates must have extensive medical claims processing experience, coding knowledge, and the ability to manage high claim volumes accurately. 🗂️ Requirements: High school diploma or equivalent, 5+ years of medical claims processing experience, Experience with professional, facility, complex, and high-dollar claims, Knowledge of ICD-10 coding, Knowledge of CPT coding, Knowledge of HCPCS coding, Understanding of medical terminology and insurance procedures, Ability to interpret insurance policies and government regulations, Proficiency with Microsoft Office Suite, Experience with claim denial resolution and appeals, Ability to manage high claim volumes, Strong attention to detail and accuracy, Ability to work independently and in a team, Availability to work Monday–Friday, 8 AM–5 PM EST 📃 Skills: ICD-10, CPT, HCPCS, HIPAA, Excel, Word, Outlook 🏢 Description: This role is Temp thru November with a chance for follow-on work. Become an integral part of a dedicated team supporting the World Trade Center Health Program. In this role, you will leverage your strong attention to detail and commitment to accuracy in processing complex medical claims. Work Schedule Remote Monday through Friday, 8:30 AM to 5:00 PM EST Must be able to work 8am - 5pm Eastern Standard Time Responsibilities Claims Review and Processing - Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. Critical Analysis - Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios. Timely Processing - Ensure prompt claims processing to meet client standards and regulatory requirements. - Identify and resolve any barriers using effective problem-solving strategies. Issue Resolution - Collaborate with internal departments to proactively resolve discrepancies and issues. - Use analytical skills to identify root causes and implement solutions. Confidentiality Maintenance - Uphold confidentiality of patient records and company information in accordance with HIPAA regulations. Detailed Record Keeping - Maintain thorough and accurate records of claims processed, denied, or requiring further investigation. Trend Monitoring - Analyze and report trends in claim issues or irregularities to management. - Assist Team Leads with reporting to contribute to continuous process improvements. Audit Participation - Engage in audits and compliance reviews to ensure adherence to internal and external regulations. - Critically evaluate and recommend process improvements when necessary. Mentoring - Mentor and train new claims processors as needed. Requirements - High school diploma or equivalent. - Minimum of five years of experience in medical claims processing, including professional and facility claims, as well as complex and high-dollar claims. - Billing experience doesn't count towards years of experience qualification. - Familiarity with ICD-10, CPT, and HCPCS coding systems. - Understanding of medical terminology, healthcare services, and insurance procedures. - Strong attention to detail and accuracy. - Ability to interpret and apply insurance program policies and government regulations effectively. - Excellent written and verbal communication skills. - Proficiency in Microsoft Office Suite (Word, Excel, Outlook). - Ability to work independently and collaboratively within a team environment. - Commitment to ongoing education and staying current with industry standards and technology advancements. - Experience with claim denial resolution and the appeals process. - Ability to manage a high volume of claims efficiently. - Strong problem-solving capabilities and a customer service-oriented mindset. - Flexibility to adjust to the evolving needs of the client and program changes. Benefits: $20-$23/hr - 401(k) with employer matching - Health insurance - Dental insurance - Vision insurance - Life insurance - Flexible Paid Time Off (PTO) - Paid Holidays

🏢 Summary: Full-time in-office LPN/MA/CNA role focused on reviewing patient charts to ensure accurate documentation and compliance within skilled nursing and long-term care settings. The position involves submitting review logs, coordinating corrections, supporting operational processes, and working with multiple healthcare systems. Offers competitive hourly pay and comprehensive benefits. 🗂️ Requirements: LPN certificate/degree or MA/CNA certification, Full-time availability, Experience reviewing patient records, Ability to submit review logs and clinical corrections, Proficiency with healthcare documentation systems, Strong time management skills, Strong communication skills, Detail-oriented approach 📃 Skills: Emsow, PointClickCare, Gmail, Sigma, Matrix, Reliable, Visual, Documentation, Healthcare, IT 🏢 Description: Job Summary We are seeking to hire a responsible, patient, and qualified Licensed Practical Nurse (LPN), Medical Assistant (MA), or Certified Nursing Assistant (CNA) to assist with reviewing patient charts. You will review patient records to ensure that information is accurate and that records and documents accurately reflect the conditions and treatment requirements of each patient. Responsibilities - Review patient records to ensure that information is accurate - Submit Review Visit Logs (RVLs) to the supervisor - Adhere to the operational guidelines for color coding of patients - Respond to HR, operational, and clinical correspondences - Submit clinical corrections to the supervisor - Attend all operational and educational pod meetings as scheduled by the pod leader and submit the post-educational survey following these meetings - Promptly communicate with Operations to resolve any IT issues encountered - Cross-train in other areas of care management - System Used: Emsow, Pointclickcare, Google Gmail, Sigma/Matrix, Reliable/Visual Requirements - LPN certificate/degree, Medical Assistant certification, or Certified Nursing Assistant certification - Ability to work full-time - Empathetic and active listener - Detail-oriented - Effective time management skills - Strong communication and interpersonal skills Benefits - Competitive salary: $30.00 an hour - $35.00 an hour - Health - Dental - Vision - Company-Sponsored Life Insurance - 401K - Paid Time Off - $1,000 Sign-on Bonus

🏢 Summary: Full-time contract role managing the end-to-end state licensing process for RNs, NPs, MDs, and DOs across all 50 states. The position focuses on coordinating applications, ensuring regulatory compliance, and maintaining accurate credentialing data to keep providers practice-ready. Requires strong experience in multi-state healthcare licensing and use of credentialing systems. 🗂️ Requirements: Minimum 2 years experience in healthcare licensing or credentialing, Experience processing state licenses for RNs, NPs, MDs, or DOs, Knowledge of multi-state licensing requirements, Familiarity with Interstate Medical Licensure Compact (IMLC), Ability to manage high-volume concurrent license applications, Experience with credentialing platforms (e.g., Verifiable or similar) 📃 Skills: Licensing, Credentialing, IMLC, Verifiable, Compliance, Documentation, Reporting 🏢 Description: About the Role We’re looking for a Medical Licensing Specialist to own the end-to-end state licensing process for our provider population across all 50 states. You’ll manage the full licensing lifecycle for Registered Nurses (RNs), Nurse Practitioners (NPs), MDs, and DOs, coordinating directly with state medical boards, providers, and internal teams to keep clinicians compliant and practice-ready. The role requires knowledge in state-specific licensing requirements, a high degree of organizational precision, and a proactive approach to issue resolution. This is a full-time, contract position at 40 hours/week, reporting into the Senior Manager, Licensing and Credentialing. Here’s what you’ll do: - Manage initial state license applications for RNs, NPs, MDs, and DOs across all 50 states, owning each application from submission through approval - Coordinate directly with providers to collect required documentation, including primary source verifications, CEU records, and background checks - Communicate with state medical and nursing boards to resolve application issues, answer inquiries, and expedite approvals where possible - Maintain current, working knowledge of state-specific licensure requirements, processing timelines, and regulatory changes - Use Verifiable to manage provider profiles, track license statuses, and generate compliance reporting for internal stakeholders - Ensure all licensing data is accurately entered and maintained in the credentialing system of record - Proactively flag and escalate issues to prevent delays in provider readiness, managing an active queue of 60+ licenses at any given time About You You are a detail-oriented and process-driven operator who takes ownership of complex, high-volume workflows. You know your way around state medical board requirements and thrive in an environment where precision and follow-through are non-negotiable. You can manage a queue of active applications, prioritize effectively, and communicate clearly with providers, boards, and internal teams alike. You are comfortable navigating ambiguity, adapting quickly when requirements shift, and escalating the right things at the right time. We would love to hear from you if you have the following or equivalent experience: - Minimum of 2 years of experience in healthcare licensing, credentialing, or a closely related field - Hands-on experience processing state licenses for RNs, NPs, MDs, and/or DOs - Familiarity with multi-state licensing requirements and the Interstate Medical Licensure Compact (IMLC) - Strong organizational skills with a demonstrated ability to manage a high volume of concurrent applications - Exceptional attention to detail and consistent follow-through on deadline-driven tasks - Experience with Verifiable or comparable credentialing platforms (preferred) - Experience in a telehealth, virtual care, or multi-state provider organization (preferred) Compensation: $25/hour

🏢 Summary: Full-time Medical Scribe role supporting providers with real-time clinical documentation, EHR management, patient intake, and front office duties in a fast-paced allergy and asthma practice. The position is suited for candidates with medical documentation experience and strong organizational and computer skills, with opportunities for healthcare students seeking clinical exposure. 🗂️ Requirements: High school diploma or equivalent, Minimum 1 year of relevant experience, Proficiency with EHR systems, Excellent computer literacy and typing skills, Knowledge of medical terminology, Ability to multitask in a fast-paced clinical environment, Strong organizational and communication skills, Attention to detail, Ability to maintain HIPAA compliance and patient confidentiality, Punctuality and reliability 📃 Skills: EHR, HIPAA, BLS, CMA, RMA, Typing, Documentation, Scheduling, Insurance, MedicalTerminology 🏢 Description: About Us Modena Health ("MH") and Modena Allergy & Asthma ("MAA") are leading and rapidly growing medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona—and ambitious plans for national expansion. We are physician-led, hospitality-focused, and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine. Known for our high standard of excellence, we provide compassionate, patient-centered care for both pediatric and adult patients. Our model combines hospitality-driven service with innovative technology solutions that streamline operations, improve clinical outcomes, and enhance the experience for both patients and providers. At Modena, we aim to hire great people, treat them well, and help them find meaning and purpose in our mission. Our dedicated team values collaboration, positivity, and growth while striving to improve lives through expert diagnosis, treatment, and research. We are looking for high-energy, kind, and collaborative individuals eager to grow personally and professionally while making a meaningful impact in the lives of others. Position Summary We are seeking a highly skilled and dedicated Medical Scribe to join our team. You will play a crucial role in providing support to the Providers in the Huntington Beach Office in managing medical documentation by summarizing their interactions with their patients. Your main responsibilities will include supporting patient visits through documentation and recording, filling out paperwork, summaries and referral letters after a visit and entering data into medical records. This position requires excellent interpersonal skills, a strong attention to detail, and the ability to multitask in a fast-paced medical environment. Great opportunity for pre-med students looking to gain experience in private medical practice. This role is non-exempt (hourly) and full time (Monday-Friday, 8-5). Key Responsibilities Patient Interaction & Intake: - Greet and prepare patients for examination, ensuring comfort and collecting relevant health information for visits. - Assist with physical exams and provider instructions. Medical Recordkeeping & Compliance: - Maintain accurate and confidential patient records in accordance with HIPAA regulations. - Assist with patient education on treatment plans, prescriptions, and overall health management. - Schedule appointments, handle patient inquiries, and manage insurance documentation. EHR & Documentation Support: - Accurately document patient encounters during office visits. - Record patient history, exam findings, diagnoses, treatment plans, and provider instructions in real-time. - Use correct medical terminology, abbreviations, and codes for documentation. - Help manage EHR and ensure all provider notes are completed and signed in a timely manner. - Assist in maintaining efficient, organized workflow in the exam room. - Collaborate with providers and clinical staff to support seamless documentation. - May assist with completing prior authorizations. Office Administration Duties: - Welcome patients and visitors, manage check-in/check-out processes, and collect co-pays. - Verify insurance, schedule appointments and follow-ups, and submit prior authorization requests. - Answer phone calls, route messages, and respond to inquiries. - Maintain organized front desk and ensure HIPAA-compliant record-keeping. - Assist in emergency situations by alerting clinical staff appropriately. - Additional duties as assigned. Qualifications & Requirements Education: - High school diploma or equivalent. Experience: - Minimum of one year of relevant experience. Licensure & Certifications: - Certification or training in medical assisting (CMA, RMA, or similar) preferred. - BLS (Basic Life Support) certification preferred or willingness to obtain. Skills & Abilities: - Excellent computer literacy and typing abilities. - Proficient in using EHR systems and medical software. - Completion of a medical terminology course or one year of experience using medical terminology in a clinical setting preferred. - Excellent organizational, communication, and multitasking skills. - Ability to manage time effectively in a fast-paced environment. - Strong attention to detail. - Commitment to maintaining patient confidentiality and adhering to HIPAA regulations. - Punctual and prepared for all shifts and work responsibilities. Preferred Qualifications: - Students pursuing careers in healthcare (medicine, nursing, PA, healthcare administration, etc.) - College-level education in health or medical-related fields - Advanced medical terminology knowledge - Fluency in a foreign language (Spanish preferred) - Advanced typing and computer proficiency - Willingness to commit to two or more years of availability Compensation The hourly range for this position is $21.50-25.00/hour. The actual compensation for this role will be determined by a variety of factors, including but not limited to the candidate's skills, education, and experience. Physical Requirements Ability to stand, walk, and move throughout the clinic for extended periods; occasionally lift objects up to 25 lbs., bend, stoop, or reach as needed. Frequent use of hands and fingers for patient care and equipment operation. Must have normal (or corrected) vision and hearing and be able to respond quickly in a fast-paced clinical environment. What We Offer - Competitive salary and benefits package, including medical, dental & vision insurance, 401(k) retirement plan with employer matching, and professional development opportunities. - Paid time off (PTO), sick time, floating holiday, and holiday pay. - Opportunity to shape the future of a thriving allergy and asthma practice. - A supportive, mission-focused culture where contributions directly impact patient outcomes and team growth. If this role excites you, please submit your resume and a cover letter outlining your relevant experience and interest in joining the team. California Consumer Privacy Act (CCPA) Notice Modena Health ("MH") and Modena Allergy & Asthma ("MAA") complies with the California Consumer Privacy Act ("CCPA"). Personal information provided in the job application process will be collected, used, and retained in accordance with applicable privacy laws.

🏢 Summary: Full-time contract opportunity for a Medical Licensing Specialist to manage end-to-end state licensing for RNs, NPs, MDs, and DOs across all 50 states. The role focuses on handling multi-state applications, coordinating with medical boards and providers, and ensuring compliance through accurate credentialing and reporting. Requires strong experience in healthcare licensing workflows and credentialing systems in a high-volume, deadline-driven environment. 🗂️ Requirements: Minimum 2 years of experience in healthcare licensing, credentialing, or related field, Hands-on experience processing state licenses for RNs, NPs, MDs, and/or DOs, Knowledge of multi-state licensing requirements, Familiarity with Interstate Medical Licensure Compact (IMLC), Ability to manage high-volume concurrent license applications, Experience maintaining accurate data in credentialing systems, Strong organizational skills and attention to detail 📃 Skills: Licensing, Credentialing, IMLC, Verifiable, Compliance, Documentation, Reporting 🏢 Description: About the Role We're looking for a Medical Licensing Specialist to own the end-to-end state licensing process for our provider population across all 50 states. You'll manage the full licensing lifecycle for Registered Nurses (RNs), Nurse Practitioners (NPs), MDs, and DOs, coordinating directly with state medical boards, providers, and internal teams to keep clinicians compliant and practice-ready. The role requires knowledge of state-specific licensing requirements, organizational precision, and a proactive approach to issue resolution. This is a full-time, contract position at 40 hours/week, reporting into the Senior Manager, Licensing and Credentialing. Here's what you'll do: - Manage initial state license applications for RNs, NPs, MDs, and DOs across all 50 states, owning each application from submission through approval - Coordinate directly with providers to collect required documentation, including primary source verifications, CEU records, and background checks - Communicate with state medical and nursing boards to resolve application issues, answer inquiries, and expedite approvals where possible - Maintain current working knowledge of state-specific licensure requirements, processing timelines, and regulatory changes - Use Verifiable to manage provider profiles, track license statuses, and generate compliance reporting for internal stakeholders - Ensure all licensing data is accurately entered and maintained in the credentialing system of record - Proactively flag and escalate issues to prevent delays in provider readiness, managing an active queue of 60+ licenses at any given time About You - Minimum of 2 years of experience in healthcare licensing, credentialing, or a closely related field - Hands-on experience processing state licenses for RNs, NPs, MDs, and/or DOs - Familiarity with multi-state licensing requirements and the Interstate Medical Licensure Compact (IMLC) - Strong organizational skills with the ability to manage a high volume of concurrent applications - Exceptional attention to detail and consistent follow-through on deadline-driven tasks - Experience with Verifiable or comparable credentialing platforms (preferred) - Experience in a telehealth, virtual care, or multi-state provider organization (preferred) Compensation: $25/hour

🏢 Summary: Full-time contract Medical Licensing Specialist role responsible for managing end-to-end state licensing for RNs, NPs, MDs, and DOs across all 50 states. The position oversees application processing, documentation collection, board communication, and compliance tracking to ensure providers remain practice-ready. Requires multi-state licensing expertise, strong organizational skills, and experience with credentialing systems. 🗂️ Requirements: Minimum 2 years of experience in healthcare licensing or credentialing, Hands-on experience processing state licenses for RNs, NPs, MDs, or DOs, Knowledge of multi-state licensing requirements, Familiarity with Interstate Medical Licensure Compact (IMLC), Ability to manage high-volume concurrent applications, Strong attention to detail and deadline management, Experience with credentialing platforms (e.g., Verifiable), Ability to coordinate with state boards and providers 📃 Skills: Licensing, Credentialing, IMLC, Verifiable, Compliance, Documentation, Reporting 🏢 Description: About the Role We’re looking for a Medical Licensing Specialist to own the end-to-end state licensing process for our provider population across all 50 states. You’ll manage the full licensing lifecycle for Registered Nurses (RNs), Nurse Practitioners (NPs), MDs, and DOs, coordinating directly with state medical boards, providers, and internal teams to keep clinicians compliant and practice-ready. The role requires knowledge of state-specific licensing requirements, strong organizational precision, and a proactive approach to issue resolution. This is a full-time, contract position at 40 hours per week, reporting to the Senior Manager, Licensing and Credentialing. Responsibilities - Manage initial state license applications for RNs, NPs, MDs, and DOs across all 50 states, owning each application from submission through approval - Coordinate with providers to collect required documentation, including primary source verifications, CEU records, and background checks - Communicate with state medical and nursing boards to resolve application issues, respond to inquiries, and expedite approvals where possible - Maintain current knowledge of state-specific licensure requirements, processing timelines, and regulatory changes - Use Verifiable to manage provider profiles, track license statuses, and generate compliance reporting - Ensure all licensing data is accurately entered and maintained in the credentialing system of record - Proactively flag and escalate issues to prevent delays in provider readiness while managing an active queue of 60+ licenses Qualifications - Minimum of 2 years of experience in healthcare licensing, credentialing, or related field - Experience processing state licenses for RNs, NPs, MDs, and/or DOs - Familiarity with multi-state licensing requirements and the Interstate Medical Licensure Compact (IMLC) - Strong organizational skills with the ability to manage high volumes of concurrent applications - Exceptional attention to detail and consistent follow-through on deadline-driven tasks - Experience with Verifiable or similar credentialing platforms preferred - Experience in telehealth, virtual care, or multi-state provider organizations preferred Compensation - $25 per hour

🏢 Summary: Full-time contract role responsible for managing end-to-end state licensing for RNs, NPs, MDs, and DOs across all 50 states, ensuring providers remain compliant and practice-ready. The position oversees application processing, documentation collection, board communication, and compliance tracking using credentialing systems. It requires strong knowledge of multi-state licensure requirements and experience handling high-volume licensing workflows. 🗂️ Requirements: Minimum 2 years of experience in healthcare licensing or credentialing, Hands-on experience processing state licenses for RNs, NPs, MDs, or DOs, Knowledge of multi-state licensing requirements, Familiarity with Interstate Medical Licensure Compact (IMLC), Ability to manage high-volume, concurrent license applications, Strong attention to detail and organizational skills, Experience with credentialing systems such as Verifiable (preferred), Experience in telehealth or multi-state provider organizations (preferred) 📃 Skills: Licensing, Credentialing, IMLC, Verifiable, Compliance, Documentation, Regulations, Reporting 🏢 Description: About the Role We’re looking for a Medical Licensing Specialist to own the end-to-end state licensing process for our provider population across all 50 states. You’ll manage the full licensing lifecycle for Registered Nurses (RNs), Nurse Practitioners (NPs), MDs, and DOs, coordinating directly with state medical boards, providers, and internal teams to keep clinicians compliant and practice-ready. The role requires knowledge of state-specific licensing requirements, strong organizational precision, and a proactive approach to issue resolution. This is a full-time contract position at 40 hours per week, reporting to the Senior Manager, Licensing and Credentialing. Responsibilities - Manage initial state license applications for RNs, NPs, MDs, and DOs across all 50 states, owning each application from submission through approval - Coordinate with providers to collect required documentation, including primary source verifications, CEU records, and background checks - Communicate with state medical and nursing boards to resolve application issues and answer inquiries - Maintain up-to-date knowledge of state-specific licensure requirements, processing timelines, and regulatory changes - Use Verifiable to manage provider profiles, track license statuses, and generate compliance reporting - Ensure all licensing data is accurately entered and maintained in the credentialing system of record - Proactively flag and escalate issues to prevent delays in provider readiness while managing an active queue of 60+ licenses Qualifications - Minimum of 2 years of experience in healthcare licensing, credentialing, or a related field - Experience processing state licenses for RNs, NPs, MDs, and/or DOs - Familiarity with multi-state licensing requirements and the Interstate Medical Licensure Compact (IMLC) - Strong organizational skills and ability to manage high-volume concurrent applications - Exceptional attention to detail and consistent follow-through on deadline-driven tasks - Experience with Verifiable or similar credentialing platforms preferred - Experience in telehealth, virtual care, or multi-state provider organizations preferred Compensation $25 per hour

🏢 Summary: Remote Registered Nurse role focused on pre- and post-payment medical reviews to ensure clinical compliance and reimbursement accuracy. The position involves evaluating medical necessity, reviewing complex claims and appeals, and documenting coverage determinations based on established guidelines. This full-time role requires strong clinical expertise, analytical skills, and experience in utilization or medical review environments. 🗂️ Requirements: Active, unrestricted RN license in the U.S. or compact multistate RN license, Associate Degree in Nursing or graduation from an accredited School of Nursing, Minimum 2 years of clinical experience, Minimum 2 years of experience in Home Health, Utilization/Medical Review, or Quality Assurance, Ability to interpret and apply medical review criteria and clinical guidelines, Proficiency in Microsoft Office and word processing software, Strong analytical and decision-making skills, Ability to work independently and manage priorities, Ability to handle confidential information 📃 Skills: MicrosoftOffice, ClinicalReview, UtilizationReview, MedicalReview, QualityAssurance, ClaimsReview, Preauthorization, Documentation, ManagedCare, HomeHealth 🏢 Description: About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements. Key Responsibilities - Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals. - Assess payment determinations using clinical information and established guidelines. - Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement. - Provide clear, well-documented rationales for service approvals or denials. - Educate internal and external teams on medical review processes, coverage determinations, and coding requirements. - Support quality control activities to meet corporate and team objectives. - Provide guidance to LPN team members and support non-clinical staff through training and discussions. - Assist with special projects and additional responsibilities as assigned. Minimum Qualifications Licensure: - Active, unrestricted RN license in the U.S. and in the state of hire OR - Active compact multistate RN license (as defined by the Nurse Licensure Compact). Education: - Associate Degree in Nursing OR - Graduate of an accredited School of Nursing. Experience: - Two years of clinical experience plus at least two years in one of the following: - Home Health - Utilization/Medical Review - Quality Assurance Skills & Competencies: - Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings. - Ability to interpret and apply medical review criteria and clinical guidelines. - Proficiency in Microsoft Office and word processing software. - Strong analytical, organizational, and decision-making skills. - Ability to work independently while managing priorities effectively. - Excellent customer service, communication, and critical thinking skills. - Ability to handle confidential information with discretion. Preferred Qualifications - Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred). - Proficiency in using multiple screens and software programs simultaneously. Benefits - All necessary equipment provided, including desktop computer, dual monitors, headset, ethernet cable, and additional accessories as needed.

🏢 Summary: Full-time contract opportunity for a Medical Licensing Specialist responsible for managing end-to-end state licensing for RNs, NPs, MDs, and DOs across all 50 states. The role focuses on handling high-volume, multi-state applications, ensuring regulatory compliance, and maintaining accurate credentialing data. This position requires hands-on experience with state licensing processes and credentialing systems in a fast-paced healthcare environment. 🗂️ Requirements: Minimum 2 years of experience in healthcare licensing or credentialing, Hands-on experience processing state licenses for RNs, NPs, MDs, and/or DOs, Knowledge of multi-state licensing requirements, Familiarity with Interstate Medical Licensure Compact (IMLC), Ability to manage high-volume, concurrent license applications, Experience maintaining accurate data in credentialing systems 📃 Skills: Verifiable, IMLC, Credentialing, Licensing, Compliance, Reporting 🏢 Description: About the Role We’re looking for a Medical Licensing Specialist to own the end-to-end state licensing process for our provider population across all 50 states. You’ll manage the full licensing lifecycle for Registered Nurses (RNs), Nurse Practitioners (NPs), MDs, and DOs, coordinating directly with state medical boards, providers, and internal teams to keep clinicians compliant and practice-ready. The role requires knowledge of state-specific licensing requirements, strong organizational precision, and a proactive approach to issue resolution. This is a full-time, contract position at 40 hours/week, reporting to the Senior Manager, Licensing and Credentialing. Responsibilities - Manage initial state license applications for RNs, NPs, MDs, and DOs across all 50 states, owning each application from submission through approval - Coordinate directly with providers to collect required documentation, including primary source verifications, CEU records, and background checks - Communicate with state medical and nursing boards to resolve application issues and answer inquiries - Maintain current knowledge of state-specific licensure requirements, processing timelines, and regulatory changes - Use Verifiable to manage provider profiles, track license statuses, and generate compliance reporting - Ensure all licensing data is accurately entered and maintained in the credentialing system of record - Proactively flag and escalate issues to prevent delays in provider readiness while managing an active queue of 60+ licenses Requirements - Minimum of 2 years of experience in healthcare licensing, credentialing, or related field - Hands-on experience processing state licenses for RNs, NPs, MDs, and/or DOs - Familiarity with multi-state licensing requirements and the Interstate Medical Licensure Compact (IMLC) - Strong organizational skills and ability to manage high volumes of concurrent applications - Exceptional attention to detail and consistent follow-through on deadline-driven tasks - Experience with Verifiable or comparable credentialing platforms (preferred) - Experience in a telehealth, virtual care, or multi-state provider organization (preferred) Compensation $25/hour