Responsible for reviewing clinical documentation and evaluating data in accordance with healthcare regulations. Ensuring confidentiality and compliance with accredited clinical criteria.
Responsibilities
Responsible for the review and evaluation of clinical information and documentation, fax triage and conversion, and provider calls.
Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements
Protects the confidentiality of member information and adheres to company policies regarding confidentiality
Data gathering requires navigation through multiple system applications.
Requirements
Active PRC - RN License
With at least 1 year hospital bedside experience
Benefits
EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.
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