Payment Integrity Nurse

Title: Senior Clinical Compliance Specialist (Payment Integrity Nurse) Position Type: Contract Location: Philadelphia, PA (Hybrid, 3 Days Per Week in Office) Compensation: Pay Range: $50.00-$53.00 Per HR Job Summary: • We’re looking for an experienced RN with coding certification (CCS, CPC, RHIA, RHIT) to join our Health Services team. • In this role, you’ll use your clinical and coding expertise to develop claim payment policies, ensure compliance with reimbursement guidelines, and support cost-saving initiatives. What You’ll Do: • Review and apply coding/clinical expertise to payment policies • Analyze utilization trends to recommend cost-effective care • Act as a subject matter expert in coding and reimbursement • Collaborate across teams to support medical cost initiatives What We’re Looking For: • RN license (PA preferred) • Coding certification required • 5+ years of clinical and coding experience (CPT, HCPCS, ICD-10) • Knowledge of reimbursement, health insurance, and Medicare regulations • Strong communication, analytical, and organizational skills Requirements: • 3+ years in clinical space – ideally as an RN • 3-5 years as a Medical Coder (not just a certification!) • Billing background Preferred: • Policy work or development • Familiarity with CMS and Medicare • Understanding of FDA and FDA approvals Contact Authorization: By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here   Benefits: Learn more about our benefits offerings here   EEO Statement: Learn more about our EEO policy here   #LI-SF1 #INDPA 25-55070

Created: 2025-09-22