Top 298 Nurse Jobs in Puerto Rico

Registered Nurse
Infosys BPM Ltd —Aguadilla, PR
- Full-time
- Bilingual
- RN License
- English
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse - Home Visits
Alura Workforce Solutions —San Juan, PR
- $45 an hour
- Part-time
- Patient monitoring
- RN License
- Mid-level
Quick Apply
Enfermero(a) Intensivista
Centro Comprensivo del Cancer UPR —San Juan, PR
- From $3,500 a month
- Full-time
Quick Apply
Enfermero(a) Graduado(a) Generalista
Centro Comprensivo del Cancer UPR —San Juan, PR
- From $3,100 a month
- Full-time
Quick Apply
7d
Care Specialist (Nurse Educator) - San Juan, Puerto Rico (National)
IQVIA —San Juan, PR
- $75,000 - $80,000 a year
- Full-time
- Microsoft Word
- Nursing
- RN License
Especialista De Determinaciones Organizacionales Y Apelaciones
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Nursing
- RN License
Especialista en Revision Medica
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Nursing
- RN License
Bsn
Fresenius —San Juan, PR
- $37.65 - $45.35 an hour
- Full-time
Quick Apply
5d
Registered Nurse (RN)
Business Staffing Solution —Aibonito, PR
- From $30 an hour
- 12 hour shift
- Nursing
- Vital signs
- Management
Quick Apply
Enfermero Generalista
Liga Puertorriquena Con —San Juan, PR
- Full-time
Quick Apply
Enfermera
Laboratorios Clínicos Villa Ana —Caguas, PR
- Full-time
- In-person
Quick Apply
VHC-ER-Enfermero (a) Generalista-STAFF
Varmed Health Center LLC —Bayamón, PR
- Up to $18.46 an hour
- Contract
Quick Apply
Enfermero-a Generalista SL Metro Cupey
HOSPITAL EPISCOPAL SAN LUCAS METRO —Cupey, PR
- $35,999.99 - $36,000.00 an hour
- Full-time
Quick Apply
6h
Registered Nurse (RN-BSN)
NeoMed Center Inc —Gurabo, PR
- $20.72 - $22.88 an hour
- Overnight shift
- Dental insurance
- 401(k)
Quick Apply
13d
Enfermero(a) Generalista - RN
Hospital Oncológico —San Juan, PR
- Full-time
- In-person
Quick Apply
7d
VHC-ER-Enfermero (a) Generalista-Contratista independiente
Varmed Health Center LLC —Bayamón, PR
- Up to $18.46 an hour
- Contract
Quick Apply
Registered Nurse (RN)
Aura med spa —Ponce, PR
- $15 - $19 an hour
- Part-time
- Flexible schedule
Quick Apply
Risk Adjustment and Coding Nurse
TPIS —San Juan, PR
- $55,000 - $65,000 a year
- Temporary
- Spanish
- Nursing
- RN License
Quick Apply
Enfermero/a Graduado/a
Manati Medical Center —Manatí, PR
- $1 a year
- Full-time
Quick Apply
Enfermera (o) Especialista Manejo de Piel area Sur- Este de PR
BEST OPTION HEALTHCARE P UERTO RICO LLC —Puerto Rico
- Full-time
- Remote
Quick Apply

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Registered Nurse

Infosys BPM Ltd -
Aguadilla, PR

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Dental insurance
Vision insurance
Life insurance

Qualifications

Bilingual
RN License
English
High school diploma or GED
Nursing

Full Job Description

Job Title: Registered Nurse
Location: Aguadilla, Puerto Rico
Puerto Rico Registered Nurse License

In this role, you will be responsible for accurate and timely processing of healthcare claim service request and processing of claims using your medical knowledge to process according to a workflow that requires the review and evaluation of the service request as per SOP.

Job responsibilities:

Responsible for accurate and timely processing of healthcare claim service request and processing claims
Reviews, evaluates the service request as per SOP
Familiar with Medical Policy, Familiar with Clinical service requests, correspondence inquiries and image review
Forward the cases to appropriate teams, post the in-scope activities have been completed as per SOP (Standard operating Procedure)
Prep medical records for clinical review
End to end processing and resolution of clinical claims and correspondence
Understand/interpret medical terminology including clinical notes and reports
Able to review medical policies and determine the appropriate claim processing or clinical review process decisions (pay, request additional records, refer for clinical review)
Review and determine pricing for clinical claims in accordance with negotiated pricing agreements
Adept knowledge of verifying member benefits, eligibility verification and medical necessity determination
To apply clinical judgement in lines of applicable guidelines while they provide post service Medical Necessity Determination (MND) reviews for Claim Policy business area led by reputed US Payer organization/s
To work in collaboration with Medical Directors to deliver top quality medical necessity determination services to clients

Basic Qualifications

High School Diploma or GED Equivalent
At least 2 years of experience relating to the job description

Preferred Qualifications

Current Puerto Rico Registered Nurse valid license
Intermediate to advanced knowledge in using MS Office and ability to learn and use various computer software
Past experience in an office/clerical setting in the medical field
Experience in any claim adjudication platform
Certification in medical coding (CPT, ICD-10
Exposure to Healthcare Claims products (Indemnity, PPO, POS/DA, EPO, HMO)
Prefer knowledge of Workman's Compensation, Medicare, COB, no fault
Prior claims experience in medical coding, case management, cost containment review, medical claim management will be preferred

Note: Applicants for employment in the U.S. must possess work authorization which does not require sponsorship by the employer for a visa (H1B or otherwise).

The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email or face to face.

Work Model:
This role is onsite 5 days per week in the office in Aguadilla.

Job Type: Full-time

Benefits:

Dental insurance
Health insurance
Life insurance
Vision insurance

Experience:

Nursing: 2 years (Required)

Work Location: In person

Quick Apply

Refine Your Search

nurse jobs in puerto rico

Registered Nurse

Registered Nurse - Home Visits

Enfermero(a) Intensivista

Enfermero(a) Graduado(a) Generalista

Care Specialist (Nurse Educator) - San Juan, Puerto Rico (National)

Especialista De Determinaciones Organizacionales Y Apelaciones

Especialista en Revision Medica

Bsn

Registered Nurse (RN)

Enfermero Generalista

Enfermera

VHC-ER-Enfermero (a) Generalista-STAFF

Enfermero-a Generalista SL Metro Cupey

Registered Nurse (RN-BSN)

Enfermero(a) Generalista - RN

VHC-ER-Enfermero (a) Generalista-Contratista independiente

Registered Nurse (RN)

Risk Adjustment and Coding Nurse

Enfermero/a Graduado/a

Enfermera (o) Especialista Manejo de Piel area Sur- Este de PR

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