Medical Records Examiner

Are you a registered nurse with a passion for utilizing your skills and professional judgment to ensure the provision of medically necessary behavioral health services? Do you thrive on learning and implementing new software applications to increase efficiency and reporting? The Office of Mental Health and Substance Abuse Services is seeking a self-motivated individual to join our Clinical Review Division team. Do not miss out on this chance to make a difference - apply now and take the first step towards a rewarding career! Work Schedule and Additional Information: Full-time employment, 37.5 hours per week Work hours are 7:00 AM to 3:00 PM, Monday - Friday, with a 30-minute lunch. Telework: You may have the opportunity to work from home (telework) full-time with the exception of reporting to the office one day per month. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. FREE parking! Salary: In some cases, the starting salary may be non-negotiable. You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

This role requires a high level of attention to detail and the ability to make well-informed decisions based on federal regulations and specific PA Medicaid programs. While the nature of this work is highly independent, collaboration and communication with coworkers, the unit supervisor, and the department consultant physicians is necessary to ensure accuracy and compliance. Your main focus will be to determine the appropriateness of behavioral health services for individuals under the age of 21, and to complete federally mandated reviews of patients with mental illness who may require nursing facility care. In this position, you will play a crucial part in ensuring that the requested services are appropriate for reimbursement by the PA Medicaid Fee-for-Service Program.