20 Best Registered Nurse jobs in Elmendorf, TX (Hiring Now!)

REMOTE Registered Nurse - Medical Review Specialist-Bexar County, Texas
Avosys Technology, Inc. —San Antonio, TX
Active and current Registered Nurse license. Conduct telephone development for missing or additional records for easily curable errors.
Estimated: $59.2K - $74.9K a year
Registered Nurse III
Dept of State Health Services —San Antonio, TX
Applicants with an out-of-state driver’s license must provide an original certified driving record from the state of driving licensure.
$7,500 - $8,463 a month
Inpatient Center Staff RN - PRN
Heart to Heart Hospice House —San Antonio, TX
Current Driver's License, reliable transportation, and provide ongoing valid and current auto liability insurance. 401k with up to 4% employer matching.
Estimated: $58.3K - $73.8K a year
Quick Apply
2d
RN, Registered Nurse - LDRP - PRN
CHRISTUS Health —San Antonio, TX
RN License in state of employment or compact BLS requiredCurrent certification from NCC Electronic Fetal Monitoring (C-EFM) or one of the following AWHONN…
Estimated: $81.9K - $104K a year
3d
Registered Nurse -Intermediate
UT Health Science Center at San Antonio —San Antonio, TX
Responsible for preparing equipment and aiding physician during treatment and examination of patients. Under limited supervision, provides direct nursing care…
ER Registered Nurse - FT Day shift
Emerus —San Antonio, TX
Current BLS, ACLS, and PALS certifications from the American Heart Association, required; ENPC certification from ENA may be substituted for PALS certification;…
Estimated: $80.2K - $102K a year
3d
Child & Adolescent Case Manager (Job #103943)
Camino Real Community Services —Floresville, TX
Proof of education required upon request and requires a valid Texas driver’s license and acceptable driving record. Prior working experience as a case manager.
$47,061 a year
Quick Apply
Occupational Health Nurse
UT Health San Antonio —San Antonio, TX
Participates in the implementation and administration of healthcare programs that enhance wellness through disease and accident prevention.
Quick Apply
11d
RN - Day Shift
Stone River Recovery Center —San Antonio, TX
Valid current RN license from the state or from a compact state, where applicable. Takes physician’s orders (verbal or via telephone) accurately and documents…
Estimated: $72.6K - $91.9K a year
Quick Apply
RN - Night Shift
Stone River Recovery Center —San Antonio, TX
Valid current RN license from the state or from a compact state, where applicable. Takes physician’s orders (verbal or via telephone) accurately and documents…
Estimated: $72K - $91.2K a year
Quick Apply
Registered Nurse FT
GCSA Ambulatory Surgery Center - Medical Center (12367) —San Antonio, TX
Must be a Registered Nurse with an unrestricted license in the state. Perform all nursing duties in accordance with the state Nursing Practice Act, while…
Estimated: $70.5K - $89.3K a year
Paramedic OR Nurse - LPN, LVN or RN
CSL Plasma —San Antonio, TX
If graduation is from a foreign allopathic or osteopathic medical school, must also currently be licensed as a physician or state certification as an emergency…
$22.25 - $36.75 an hour
Quick Apply
Hospice RN
Divinity Hospice —San Antonio, TX
RN license to practice in the state. One on one interaction wherever the patient calls home. Our support system of medical, social, psychological and spiritual…
$75 an hour
Quick Apply
RN, Registered Nurse - ECC Emergency Care
CHRISTUS Health —San Antonio, TX
The Registered Nurse (RN) provides clinical supervision for entry level nurses and assists in their development. Associate's Degree in Nursing.
Estimated: $77.9K - $98.6K a year
10d
Cath Lab and Special Procedures Nurse (RN)
The SAVE Clinic —San Antonio, TX
Additional Duties: - Additional duties may include any and all tasks related to medical office operations, including but not limited to answering phones,…
$38 - $50 an hour
Quick Apply
11d
Assistant Director of Nursing Services (ADON)
Prairie Meadows Rehabilitation and Healthcare Center —Floresville, TX
Current RN / LVN/ LPN license in state of practice. Receives calls and finds replacements for absent staff. Pay based on licensing and experience.
Estimated: $62.1K - $78.6K a year
Quick Apply
Registered Nurse Neuro Tele
Methodist Hospital —San Antonio, TX
Education assistance (tuition, student loan, certification support, dependent scholarships). Referral services for child, elder and pet care, home and auto…
Quick Apply
1d
Freestanding Emergency Room Registered Nurse
Metropolitan Methodist Emergency Center —San Antonio, TX
Education assistance (tuition, student loan, certification support, dependent scholarships). Minimum of six (6) months of clinical experience as a licensed…
Quick Apply
1d
Treatment Nurse - LVN /RN Nursing Home
Harbor Valley Health & Rehabilitation —San Antonio, TX
_All full time staff may participate in the company matching 401 (k) program. Tracking and trending progress and interventions. Round with Wound Care Physician.
Estimated: $54.7K - $69.3K a year
Quick Apply
4d
Utilization Management Nurse
GMG Health Systems, LTD —San Antonio, TX
Education and Training: Active, unencumbered Registered Nurse with an associate degree or must be state-licensed practical nurse with one year of LVN or RN…
Estimated: $63.4K - $80.2K a year
Quick Apply

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REMOTE Registered Nurse - Medical Review Specialist-Bexar County, Texas

Avosys Technology, Inc. - San Antonio, TX

Apply Now

Job Details

Estimated: $59.2K - $74.9K a year

Benefits

Disability insurance
Health insurance
Dental insurance
401(k)
Vision insurance

Qualifications

RN License
Microsoft Office
Computer skills
2 years
Communication skills

Full Job Description

Overview:

Avosys is a growing integrator of professional, technological and management solutions services. Founded in 1998, Avosys provides services nationwide to Federal, Commercial, Local and State clients. We recognize the foundation of our firm is our people and we continue to rise above our competition by hiring the best.

Avosys is seeking a Bexar County Remote Registered Nurse - Medical Review Specialist to work remotely to review Medicare claims..

Maximize family time with no weekend, Holiday, or on-call requirements
Maintain work-life balance with guaranteed 8-hour shifts
Take advantage of our competitive, comprehensive benefits package including medical, dental, vision, life, short-term disability, long-term disability & 401(k)

Responsibilities:

Perform clinical reviews of Medicare Part A and Part B claims for Medical Review, Redeterminations/Appeals (Appeals), and Prior Authorization requests (collectively, the “Services”) in accordance with CMS (Centers for Medicare & Medicaid Services) requirements
Complete a projected number of clinical review hours while meeting timeliness and accuracy standards and completing documentation of clinical decisions for remittance.

Clinical review of services

Review medical record documentation within CMS timeliness parameters (i.e., 20 days from receipt of the medical record for pre-payment reviews and 50 days from receipt of the medical record for post payment reviews)
Utilize the applicable Medicare policies (i.e., Local Coverage Determinations, National Coverage Determinations, Internet-Only Manual (IOM) citations, inpatient tools, etc.) to ensure the services comply with all Medicare regulations and documentation requirements
Review documentation for medical necessity per guidelines outlined in the Social Security Act 1862(a)(1)
Ensure that all documentation includes a valid signature consistent with the signature requirements

Documentation of rationale for processing decisions

Provide a claim sample of three (3) claims to Companies via established protocols and timeliness parameters (i.e., 18 days from receipt of the medical record for pre-payment reviews and 48 days from receipt of the medical record for post payment reviews) for quality review prior to finalization of documentation of reason for payment, reduction, or denial of service to ensure accuracy of claim decision making
Companies will review the three-claim sample for accuracy of claim decision and will make and return decisions to the MRS within 24 hours or less
Complete the documentation of the reason for payment, reduction, or denial of service for all claims on an electronic decision template to be provided by Companies. This rationale must be in sentence format so that it may be inserted directly into the response to the provider, must be clear and well-written, and contain sufficient information to educate the providers on how the review decision was made
Return documented decision electronically to Companies via established protocols and timeliness parameters (i.e., 20 days from receipt of the medical record for pre-payment reviews and 50 days from receipt of the medical record for payment reviews)
Complete the review results letter in the Companies’ letter writing system within 35 days from receipt of the medical record for pre-payment reviews and no later than 60 days from receipt of the medical record for post payment reviews
Document all case activity in Companies’ provider tracking system on the day the activity occurs
Complete one-on-one provider education (i.e., webinar, conference call, etc.) within 30 days of sending out review results letter
Respond to provider inquiries related to case and/or claims throughout the course (i.e. in 24 hours or less) of review
If additional clinical guidance is required, complete the Contractor Medical Director (“CMD”) assistance form, track response, and update review accordingly
Conduct telephone development for missing or additional records for easily curable errors
Notate date of receipt of additional documentation received in the Companies’ provider tracking system
Upon request by Companies, initiate or participate in provider teaching activities, creating written teaching material, providing one-on-one education or education to a group as a result of an MR review
If fraud activity is suspected, immediately complete initial referral packet for external entity referral and return the packet to the Companies
Complete referrals to Companies’ provider outreach and education (“POE”) area in provider tracking system for cases that have a moderate or major error rate
Lead and Alternate Lead will participate in all monthly departmental training and meetings, and all Staff will participate as requested
Submit all cases for review and approval for quality and closure of cases

Qualifications:

Minimum of two (2) years’ clinical experience
Excellent written and oral communication skills
Demonstrated experience with evaluating medical and health care delivery issues
Strong computer skills to include Microsoft Office proficiency

License - Certifications:

Active and current Registered Nurse license

Other Information:

Industry: Defense

US Citizenship Required: Yes

Background Check: Required

Current Clearance Level Required: None

Telework: Yes but Resides in Bexar County, Texas

Travel: No

Equal Opportunity Employer/Veterans/Disabled

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this on-line application process and need an alternative method for applying, you may contact (210) 888-0775 or Jobs@Avosys.com for assistance.

Apply Now

Registered Nurse jobs in Elmendorf, TX

REMOTE Registered Nurse - Medical Review Specialist-Bexar County, Texas

Registered Nurse III

Inpatient Center Staff RN - PRN

RN, Registered Nurse - LDRP - PRN

Registered Nurse -Intermediate

ER Registered Nurse - FT Day shift

Child & Adolescent Case Manager (Job #103943)

Occupational Health Nurse

RN - Day Shift

RN - Night Shift

Registered Nurse FT

Paramedic OR Nurse - LPN, LVN or RN

Hospice RN

RN, Registered Nurse - ECC Emergency Care

Cath Lab and Special Procedures Nurse (RN)

Assistant Director of Nursing Services (ADON)

Registered Nurse Neuro Tele

Freestanding Emergency Room Registered Nurse

Treatment Nurse - LVN /RN Nursing Home

Utilization Management Nurse

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