Nurse Consultant
Blue Cross and Blue Shield of Kansas(1 month ago)
About this role
The Nurse Consultant at Blue Cross and Blue Shield of Kansas is responsible for the day-to-day operations of reviewing and processing predeterminations, claims, appeals, and related inquiries while utilizing independent decision-making aligned with medical policies. This role serves as a primary resource for internal staff regarding medical policy, correct coding, medical necessity, and claims adjudication processes.
Required Skills
- Clinical Nursing
- Claims Adjudication
- Medical Policy
- Analytical Skills
Qualifications
- High School Diploma
- Kansas RN Licensure
- 3 Years Clinical Nursing Experience
About Blue Cross and Blue Shield of Kansas
bcbsks.comHealth insurance and dental plans, related health care benefits for Medicare, individual or group health insurance. Manage your health care choices with BCBSKS.
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