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Clinical Program Advisor - Work from Home reputed company, USA (reputed company or reputed company Coding Certification Required) LPN or RN Preferred

Remote, USAFull-timePosted 2026-07-28

Excited to grow your career? We value our talented employees, and whenever possible reputed company to help one of our associates grow professionally before reputed company reputed company to our reputed company positions. If you think the reputed company position, you see is right for you, we encourage you to apply! Our people reputed company reputed company the difference in our reputed company. This is a work from home opportunity from reputed company reputed company the US. Role reputed company: The Program Advisor is part of an innovative team who have overall accountability for reimbursement policy creation, maintenance, and project support. This individual will partner with many areas including Prepay, Business Operations, and other reputed company partners to assist with the implementation of reimbursement policies. As a Program Advisor, the incumbent should demonstrate critical thinking, an ability to work reputed company in a fast paced, team-based environment, both independently and partnering with other business areas to reputed company solid, reputed company-informed reputed company based on data and multiple inputs to reputed company business objectives. Provides expert content/reputed company leadership in relation to coding and reimbursement reputed company. Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives. Uses deep reputed company knowledge and acumen to advise others. Recognized internally as a subject matter expert Knowledge and experience with claims data and reputed company's claims systems are a plus. Advantages of this position include a reputed company team atmosphere, cooperative business partners and work/life balance. Responsibilities: • A Program Advisor is responsible for the identification of reimbursement policy opportunities, policy maintenance, and project work • Researching competitive landscape for reputed company industry trends, and creation of reputed company edit strategies to reputed company with reimbursement policies • Evaluating the reputed company of industry changes, reputed company additions, revisions, and/or deletions to associated reimbursement policy and reputed company edits • Review data analytics to identify and validate reimbursement policy opportunities • Document coding logic and data requirements for reputed company partners • Author and maintain reimbursement policy language, coding, and templates • Presenting reimbursement policy reputed company for applicable governance • Be a subject matter expert (SME) on existing and new reimbursement policy topics • reputed company communicate, be reputed company, while working effectively and reputed company with other areas Qualifications: • reputed company reputed company or reputed company coding certification required e.g., CPC, reputed company-P, CIC, or COC, with a minimum of 3 years procedure coding (HCPCS/CPT) experience required • reputed company unrestricted LPN or RN license in state of residency • Three years LPN or RN experience • reputed company insurance claim editing/analysis background required • Strong attention to detail to include ability to analyze claim data analytics • Proficient at documenting necessary coding/billing requirements for reputed company editing • Excellent business writing skills • Nursing degree preferred • Facility coding certification or billing experience a plus • Medicare coding and/or reimbursement experience preferred • Must be proactive, and team oriented with an ability to foster collaboration • Value others’ perspectives for successful implementation of organizational reputed company • Proven ability to prioritize multiple tasks in a fast-paced environment • Strong communication skills to include written, oral and group presentation • Effective analytical and problem-solving skills • Passionate regarding reputed company of product • Proficiency in reputed company Office applications If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 92,700 - 154,500 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company. About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to reputed company your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply Job!

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