Nurse Reviewer

Résumé du poste

The Nurse Reviewer is responsible for reviewing medical claims to ensure compliance with company policies and legal practices. This includes conducting management reporting, maintaining source documents, and communicating effectively with clients and team members.

Détails du poste

At Epiq, your work contributes to complex, global legal outcomes. You’ll join a values‑driven community where integrity guides decisions, relentless service sets the bar, and we thrive on big challenges together. We invest in your growth with enterprise‑wide learning and mobility. We celebrate who you are, and we respect life beyond work with flexibility that’s recognized externally. Enabled by modern platforms and AI, you’ll do the most meaningful work of your career and see your impact at scale. Job Description: Job Summary The Nurse Reviewer is responsible for reviewing medical claims, ensuring compliance with company policies and legal practices. This role requires strong communication, confidentiality, and analytical skills. Essential Job Responsibilities Review medical claims and ensure compliance with company policies and legal practices. Conduct management reporting and maintain source documents. Communicate effectively with clients and team members. Maintain professional etiquette and organizational abilities. Qualifications & Requirements Education: Bachelor's degree in nursing or a related field. Experience: 3-5 years of experience in medical claims review or a related role. Skills: Communication Company Policies Confidentiality Languages Legal Practices Management Reporting Source Documents Standard Operating Procedure (SOP) Supervision Written Communication Certifications: Required: None Preferred: Registered Nurse (RN) License, Certified Professional in Healthcare Quality (CPHQ), Legal Nurse Consultant Certified (LNCC) Physical Requirements: Ability to work in an office environment and perform tasks that may require sitting, standing, and using office equipment. Your specific salary will be determined based on several factors: Location-based market rate for the role Your abilities in relation to the job specification Performance during screening and interview Pay parity with the wider team in the considered location Further details about the package will be provided during the initial screening call with the Talent Acquisition Team. Click Here To Learn About Epiq's Benefits. Epiq Leadership Compass Fosters Relationships & Collaboration Builds trust and alignment through open communication, shared goals, and strong partnerships to drive collective success. Build trust-based partnerships Nurture long-term relationships Remove collaboration barriers Celebrate cross-team success Engages & Influences Inspires action and alignment through clear communication, purposeful influence, and a compelling vision. Use storytelling to build buy-in Align communication with organizational goals Guild alignment through strong engagement Maximizes Performance Sets and reinforces performance standards that drive results, ensure accountability, and align with Epiq’s goals. Use data to identify improvement opportunities Make informed decisions Align team goals with boarder strategy Empower teams to manage their own goals Translate vision into clear priorities Prepare for disruptions with strong change management Achieves Operational Success Drives continuous improvement and operational excellence through smart processes, data insights, and quality execution. Improve workflows for team efficiency Use clear documentation and expectations Resolve issues quickly using data and feedback It is Epiq’s policy to comply with all applicable equal employment opportunity laws by making all employment decisions without unlawful regard or consideration of any individual’s race, religion, ethnicity, color, sex, sexual orientation, gender identity or expressions, transgender status, sexual and other reproductive health decisions, marital status, age, national origin, genetic information, ancestry, citizenship, physical or mental disability, veteran or family status or any other basis protected by applicable national, federal, state, provincial or local law. Epiq’s policy prohibits unlawful discrimination based on any of these impermissible bases, as well as any bases or grounds protected by applicable law in each jurisdiction. In addition Epiq will take affirmative action for minorities, women, covered veterans and individuals with disabilities. If you need assistance or an accommodation during the application process because of a disability, it is available upon request. Epiq is pleased to provide such assistance and no applicant will be penalized as a result of such a request. Pursuant to relevant law, where applicable, Epiq will consider for employment qualified applicants with arrest and conviction records.

Ce que vous ferez

The Nurse Reviewer is responsible for reviewing medical claims to ensure compliance with company policies and legal practices. This includes conducting management reporting, maintaining source documents, and communicating effectively with clients and team members.

Exigences

Candidates must have a Bachelor's degree in nursing or a related field and 3-5 years of experience in medical claims review. Professional certifications such as RN, CPHQ, or LNCC are preferred.

Compétences indiquées

• written communication · Souhaitée
• Management Reporting · Souhaitée
• Compliance · Souhaitée

Autres compétences pertinentes

Relevées dans la description du poste. Confirmez les exigences importantes ci-dessus.

• Medical Claims Review
• Compliance
• Management Reporting
• Confidentiality
• Written Communication
• Standard Operating Procedure (SOP)
• Legal Practices
• Analytical Skills

Domaines d’emploi

• Healthcare
• Legal
• Management & Leadership