Associate Nurse

Role Overview: As an Associate Nurse (BSc), your main function will be to facilitate the delivery of applicable benefits to ensure cost-effective outcomes for all members requiring services. Key Responsibilities: - Review and evaluate services being appealed based on available information and medical policy - Assess documentation to determine if services performed were appropriate according to clinical policies and guidelines - Utilize all available system information and additional records/data to make determinations or recommendations - Gather data by navigating through multiple system applications - Demonstrate comprehensive knowledge of complex delegation arrangements, contracts, clinical criteria, benefit plan structure, regulatory requirements, company policy, and other processes necessary to support clinical documentation/information review - Apply regulatory and accreditation standards consistently to ensure activities are reviewed and processed within guidelines - Summarize complex information into a clear clinical picture - Independently prepare clinical summaries for medical doctor review and provide recommendations when needed - Perform detailed inspection of handwritten and computer-generated documents as well as PC monitor Qualification Required: - India Registered Nurse with an active BSc Nurse license - Minimum 2 years of clinical experience - Practical experience in various nursing fields such as hospital, industrial, community, outpatient, and clinical settings Additional Details: This is a full-time position located in Kochi, Kerala. Night shift availability is required for this role. The benefits include health insurance, paid sick time, and Provident Fund. Bachelor's degree is required for this position. (Note: No additional details about the company were provided in the job description),