Nurse Consultant – NCLEX
Industry: BPO / US Healthcare
Location: Infopark, Kakkanad, Kochi
Shift: 6:00 PM to 3:00 AM, Monday to Friday
Weekly Off: Saturday and Sunday
Eligibility Criteria
License: NCLEX-RN certification is mandatory.
Qualification: BSc Nursing / Post BSc Nursing only.
Experience: Freshers can apply, provided they are NCLEX-RN certified.
Communication: Excellent fluency in English is required.
Required Skills
- Strong clinical knowledge and nursing background.
- Good understanding of medical terminology and patient care documentation.
- Excellent English communication skills.
- Ability to work in a US healthcare process environment.
- Willingness to work in evening/night shift.
Responsibilities
- Review and analyze medical claims, provider appeals, and dispute cases within the US healthcare insurance process.
- Evaluate clinical documentation, medical records, and supporting evidence to determine medical necessity and appropriateness of care.
- Assess healthcare claims using clinical guidelines, payer policies, and utilization management criteria.
- Collaborate with physicians, healthcare providers, and internal teams to gather and review additional clinical information.
- Ensure compliance with US healthcare regulations, insurance policies, payer guidelines, and quality standards.
Pay: ₹105,000.00 - ₹115,000.00 per month
Benefits:
- Commuter assistance
- Health insurance
- Provident Fund
Experience:
License/Certification:
- NCLEX RN (Required)
- BSC Nursing/Post BSC (Required)
Shift availability:
Work Location: In person
