Job Description
CHCS is a company positioned for growth and excellence. It may not be an exciting time in the marketplace, so we aim to shake things up. We are looking at acquiring more companies and we have already begun to place a larger investment in technologies and tools for our associates and our customers.Our storyWe’ve been in business for over 30 years. We are a global company with delivery centers in the USA and INDIA. CHCS is an award-winning insurance third-party administrator (TPA) of senior health products. We are in the business of providing state-of-the-art administrative support services and customized care solutions to manage policies and claims. CHCS Supports some of the largest senior market insurance companies in the world. Processing hundreds of thousands of claims every year and our vast network of experienced registered nurses and healthcare professionals provide personalized care management services to policyholders.The futureWithin the next 5 years we are seeking to become THE leader in the TPA services marketplace! To achieve this goal, we know we’ll need to build an even stronger team. We are ready to invest in the company and in you.Investment in technologies: new call center technology is Five9s, and continually refresh of systems.Job Summary:
The Assessment Team Clinical Nurse Reviewer is responsible for the timely and accurate review of completed cognitive and functional assessments conducted for Long-Term Care Insurance policyholders. Assessments included are on-site, video, telephonic recertification and telephonic for private caregivers. Interacting with assessors, the Clinical Nurse Reviewer obtains necessary clarifications to documentation submitted, provide training to assessors who are new or need retraining on completing assessments and conducts telephonic assessments with other health care providers when an assessment/reassessment is needed for a claimant residing in a long-term care facility. The Clinical Nurse Reviewer reviews clinical questions from long term care insurers. The Clinical Nurse Reviewer documents and provides input on the quality of assessors upon completing their review.
Essential Job FunctionsReviewing completed assessment documents