Payment Integrity Clinician – UNRESTRICTED RN LICENSE (Remote: OR, WA, ID, or UT))

Remote Full-time
Payment Integrity Clinician – UNRESTRICTED RN LICENSE Motus is partnering with a leading healthcare provider to identify an experienced Payment Integrity Clinician – UNRESTRICTED RN LICENSE for a contract opportunity. This role is responsible for conducting prepayment, post-payment, and audit reviews of claims to ensure accurate coding, appropriate reimbursement, and compliance with clinical and regulatory standards. The clinician applies nursing expertise and leverages internal policies, reimbursement guidelines, and national coding standards to support claim determinations, ensuring accuracy, consistency, and adherence to accepted standards of care. Contract Duration: 6 -Months Work Model: 100% Remote (Must reside within OR, WA, ID, or UT) Pay Range: $39.00 - $43.00/hr. DOE Benefit Eligibility: Yes Schedule: • Must be able to work PST hours • May require availability for evenings, weekends, holidays, and overtime as needed Equipment: Client-provided equipment; internet must be Cable, DSL, or Fiber (no satellite or mobile Wi-Fi) Responsibilities of a Payment Integrity Clinician – UNRESTRICTED RN LICENSE: • Applies nursing expertise to ensure compliance with medical, reimbursement, and care standards • Reviews claims and medical records to ensure accurate and appropriate payment • Ensures documentation meets federal regulations, company policies, and industry standards • Collaborates with physician advisors and internal teams to support clinically sound determinations and resolve claims issues • Communicates professionally with internal and external stakeholders while maintaining confidentiality • Prioritizes and manages workload to meet performance standards and timelines • Maintains clinical competency through ongoing education and required licensure/certifications • Working knowledge of clinical coding practices and applications Qualifications of a Payment Integrity Clinician – UNRESTRICTED RN LICENSE: • Bachelor’s degree in health/human services (Master’s or Psychiatric RN preferred) or current unrestricted RN license • Unrestricted licensure/certification in OR, WA, ID, or UT enabling independent clinical assessment • Minimum 3 years of clinical, health insurance, claims review, or case management experience • Knowledge of medical procedures and ability to interpret medical records and apply clinical/reimbursement policies • Strong analytical, problem-solving, and communication skills • Proficient in Microsoft Office; able to learn systems quickly; detail-oriented and able to multitask independently in a fast-paced environment • Preferred: Certified Professional Coder (AAPC or AHIMA) • *We are unable to accommodate corp. to corp. candidates** About Motus Recruiting and Staffing, Inc: Founded in 2006, Motus is an award-winning recruiting and staffing firm in the Pacific Northwest, specializing in professional services and technology solutions. We are a group of people who not only recognize the importance of representation, but actively fight for diversity, equity, and inclusion in the recruitment process. Our goal is to educate organizations on the importance of DEI when hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status. PG/BH 13841
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