Based in Tigard, Oregon, Motus is a privately held, full-service staffing and recruiting firm specializing in the accounting and finance, office and management,
Payment Integrity Clinician I
Location
Oregon + 3 moreAll locations: Oregon | Washington | Idaho | Utah
Posted
36 days ago
Salary
$39 - $43 / hour
Seniority
Senior
Job Description
Payment Integrity Clinician I
Motus Recruiting & Staffing
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)
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