Top 17 Nurse clinical reviewer Jobs in Florida

Second Level Reviewer I PRN Remote
AdventHealth Corporate —Altamonte Springs, FL
- $31.82 - $59.17 an hour
- PRN
- Remote
- Background check
- Nursing
- RN License
- Paid parental leave
- Disability insurance
DRG Nurse Reviewer Appeals and Hearings- Remote
Gainwell Technologies —Florida
- $95,000 - $110,000 a year
- Full-time
- Remote
- RN License
- Presentation skills
- Travel
- Health insurance
- Tuition reimbursement
Clinical Nurse Reviewer
Zelis —Saint Petersburg, FL
- $59,000 - $75,050 a year
- Full-time
- Nursing
- RN License
- Inventory management
- Paid holidays
- Disability insurance
Second Level Reviewer I
AdventHealth Corporate —Altamonte Springs, FL
- $66,170.74 - $123,073.07 a year
- Full-time
- Background check
- Nursing
- RN License
- Paid parental leave
- Disability insurance
Utilization Reviewer 2
Enlyte —Tampa, FL
- $59,500 - $76,000 a year
- Full-time
- RN License
- Mid-level
- Office
- Health savings account
- AD&D insurance
OASIS Reviewer
Revival Home Health Care a Centers Company —Margate, FL
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
UM Clinical Reviewer
Centers Plan for Healthy Living —Margate, FL
- Full-time
- RN License
- Communication skills
- Entry level
Quick Apply
Utilization Management Reviewer
Mental Health Resource Center —Jacksonville, FL
- Full-time
- Background check
- Nursing
- Psychiatry
- Paid holidays
- Disability insurance
Quick Apply
(Part-Time) Legal Nurse Case Reviewer | Orthopaedics / Neurosurgery | Onsite
Shimspine —Oldsmar, FL
- Part-time
- Nursing
- RN License
- 5 years
- Paid training
- Flexible schedule
Quick Apply
Utilization Management Rep I (contract)
Elevance Health —Tampa, FL
- Call employer
- Hybrid work
- High school diploma or GED
- US work authorization
- Data entry
- Health savings account
- Disability insurance
Physician Reviewer
Independent Living Systems —Miami, FL
- Medicine
- HIPAA
- Mid-level
Quality Reviewer (RN or PT)
VNA of the Treasure Coast —Vero Beach, FL
- Part-time
- Background check
- CPR Certification
- RN License
- Continuing education credits
- 403(b) matching
Quick Apply
2d
Manager, Clinical Appeals
Health Business Solutions LLC —Cooper City, FL
- Nursing
- RN License
- 5 years
DIR - UTILIZATION REVIEW / MGMT
Wekiva Springs Center —Jacksonville, FL
- Full-time
- Nursing
- Management
- RN License
Psychologist Reviewer
BHM Healthcare Solutions —Tampa, FL
- $38 - $48 an hour
- Full-time
- Hybrid work
- Background check
- Writing skills
- Office
- Health insurance
- Dental insurance
Quick Apply
8d

Discover related jobs

Based on your search for nurse clinical reviewer jobs.

Inpatient DRG Reviewer
Zelis —Florida
As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews…
$79,000 - $99,750 a year
Second Level Reviewer I PRN Remote
AdventHealth Corporate —Altamonte Springs, FL
Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Paid Time Off from Day One.
$31.82 - $59.17 an hour

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Clinical Reviewer - Medical Coder & QA
Ohio Living —Westerville, OH
Current unencumbered license for the state of Ohio to practice as a Licenses Practical Nurse (LPN) preferred Certificate for OASIS Specialist-Clinical…
Quick Apply

I want to receive the latest job alert for nurse clinical reviewer in florida

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

nurse clinical reviewer jobs near florida

Second Level Reviewer I PRN Remote

AdventHealth Corporate -
Altamonte Springs, FL

Apply Now

Job Details

PRN
$31.82 - $59.17 an hour

Benefits

Paid parental leave
Disability insurance
Health insurance
Dental insurance
Paid time off
Parental leave
Vision insurance
403(b)
Benefits from day one
Life insurance

Qualifications

Triage
Acute care facility experience
Typing

Full Job Description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Well-being Resources
Mental Health Resources and Support
Pet Benefits

Schedule:

PRN

Shift:

Day (United States of America)

Address:

900 HOPE WAY

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32714

Job Description:

Reviews concurrent medical records for documentation compliance, including completeness and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality. Completes accurate and timely record reviews to ensure the integrity of documentation compliance. Inputs data into CDI Software accurately and concisely, resulting in precise metrics obtained through the reconciliation process. Recognizes opportunities for documentation improvement using strong critical-thinking skills and sound judgment. Initiates and formulates CDI severity worksheets and clinically credible clarifications for inpatients, presenting opportunities for improved documentation compliance to physicians, nurse practitioners, and other clinical team members. Transcribes documentation clarifications as appropriate for SOI, ROM, PSI, HCCs, and HACs to ensure documentation compliance. Educates members of the patient-care team regarding documentation regulations and guidelines, including physicians, allied health practitioners, and nursing, with quarterly and annual compliance updates from Medicare. Communicates effectively and appropriately with physicians and other healthcare providers to ensure accurate and complete clinical documentation. Collaborates with HIM staff to resolve discrepancies with DRG assignments and other coding issues. Completes well-timed follow-up case reviews on all cases, prioritizing resolution of those with clinical documentation clarifications. Participates in department meetings, providing feedback on outstanding issues, presentations for educational opportunities, and addressing needs identified by CDI leaders. Assumes personal responsibility for professional growth, development, and continuing education to maintain a high level of proficiency. Performs other duties as assigned.

Knowledge, Skills, and Abilities:

Excellent interpersonal skills including excellent verbal and written communication skills; proficient in and demonstrates excellent physician relations. [Required]
Able to organize and present information clearly and concisely; excellent computer and keyboarding skills; ability to use multiple software programs simultaneously; high degree of prioritization skills. [Required]
Ability to learn/develop and fine-tune the skills necessary to perform optimally as a Clinical Documentation Specialist. [Required]
Dependable, self-motivated and pleasant. [Required]
Utilize and demonstrate excellent critical-thinking, problem-solving and deductive-reasoning skills. [Required]
Knowledge of pathophysiology, disease processes and treatments. [Required]
Strong ability to organize/triage work and manage multiple priorities at once. [Required]
Knowledge of clinical documentation requirements that identify clinical conditions or procedures. [Preferred]
Coding background. [Preferred]
Knowledge of quality guidelines. [Preferred]

Education:

Bachelor's of Nursing [Required]
Master's [Preferred]

Field of Study:

in healthcare related field

Work Experience:

5+ years acute care nursing experience with specific medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience. [Required]
3+ years of Clinical Documentation Specialist experience [Required]

Additional Information:

An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:- BSN and 3+ years of Clinical Documentation Specialist experience OR - 4+ years of Clinical Documentation Specialist experience OR - Less than 2 years of Clinical Documentation Integrity experience and 10 years of acute care nursing experience.

Licenses and Certifications:

Registered Nurse (RN) [Required] OR
Physician Assistant (PA) [Required] OR
Advanced Practice Registered Nurse (APRN) [Required] OR
Certified Clinical Documentation Specialist (CCDS) [Required]
Certified Billing and Coding Specialist (CBCS) [Preferred]
Certified Cardiac Device Specialist (CCDS) [Required]

Physical Requirements: (Please click the link below to view work requirements)

Physical Requirements -https://tinyurl.com/23km2677

Pay Range:

$31.82 - $59.17

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Apply Now

Refine Your Search

nurse clinical reviewer jobs in florida

Second Level Reviewer I PRN Remote

DRG Nurse Reviewer Appeals and Hearings- Remote

Clinical Nurse Reviewer

Second Level Reviewer I

Utilization Reviewer 2

OASIS Reviewer

UM Clinical Reviewer

Utilization Management Reviewer

(Part-Time) Legal Nurse Case Reviewer | Orthopaedics / Neurosurgery | Onsite

Utilization Management Rep I (contract)

Physician Reviewer

Quality Reviewer (RN or PT)

Manager, Clinical Appeals

DIR - UTILIZATION REVIEW / MGMT

Psychologist Reviewer

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for nurse clinical reviewer in florida

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected