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Job Description:
Duties and Responsibilities

  • Performs post payment analysis of medical claims and records.
  • Uses independent judgment to determine sanction level, and forwards recommendation to management for approval.
  • Prepares reports and correspondence.
  • Researches policy/ standards.
  • Meets established production requirements consistently.
  • Demonstrates and understand of the skills needed, but needs coaching

State Plan / Department Specific Duties and Responsibilities

  • Close assigned cases.
  • Demonstrates consistent movement of cases towards closure.
  • Demonstrates good quality work in conjunction with efficient case movement.
  • Demonstrates knowledge and understanding of SURS procedures and process.
  • Contributes a positive attitude in order to meet goals.
  • Utilizes J-SURE (or equivalent) system with minimum assistance.

Knowledge, Skills and Abilities

  • Strong analytical skills.
  • Computer knowledge including Microsoft Word and Excel.
  • Knowledge of coding, billing, and chart review experience.
  • Excellent verbal and written communication.
  • Ability to abide by DXC's policies.
  • Ability of maintain attendance to support required quality and quantity of work.
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, member, providers and customers.
  • Participates in teams necessary for department goals.

Required Qualifications

  • Associates Degree in Nursing
  • 2 years nursing experience
  • Current Louisiana RN license

Preferred Qualifications

  • CPT/ICD-9 coding experience

Registered Nurse Analyst

DXC Technology

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