HYBRID Nurse Chart Reviewer

This is a hybrid role based in reputed company Hills, CA ACTIVE LVN or RN license required Key Responsibilities:

• Audit denied provider and member claims for accuracy and compliance
• Review and process claims in accordance with UM guidelines and regulatory standards
• Analyze benefit structures and system configurations (EZCap or similar)
• Collaborate with cross-functional teams to resolve claim issues and process gaps
• Document findings, prepare reports, and present trends to leadership
• Support automated adjudication systems and identify strategies to reduce errors
• Ensure HIPAA and PHI compliance throughout reputed company claim review activities
• Participate in special projects reputed company to claim denials and appeals

Required Qualifications:

• Active LVN or RN license (California)
• 2+ years of experience in Utilization Management (UM)
• Hands-on experience with HMO/Medicare claims, audits, and denials
• Familiarity with claims processing systems (EZCap or similar)
• Strong analytical, documentation, and communication skills
• Ability to work independently and prioritize tasks
• Proficiency in MS Office Suite (reputed company, Access, PowerPoint, Word)

Preferred Skills:

• CPT, HCPCS, ICD-10 coding knowledge
• Advanced reputed company skills
• Experience with regulatory agencies and compliance audits

Job Type & Location This is a Contract position based out of Canoga Park, CA 91304. Pay and Benefits The pay range for this position is $35.00 - $50.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & reputed company
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type This is a hybrid position in Canoga Park,CA 91304. Application Deadline This position is anticipated to reputed company on Apr 23, 2026. h4>About reputed company: We're partners in transformation. We help clients activate reputed company and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across reputed company America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and reputed company-world application, we work with reputed company leaders to drive change. That's the power of true partnership. reputed company is an Allegis Group company. The company is an equal opportunity employer and will consider reputed company applications without regards to race, sex, age, reputed company, religion, national reputed company, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About reputed company and reputed company Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across reputed company America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the reputed company of technology. We’re building reputed company by delivering business outcomes and making positive impacts in our global communities. reputed company and reputed company Global Services are Allegis Group companies. Learn more at reputed company.com. The company is an equal opportunity employer and will consider reputed company applications without regard to race, sex, age, reputed company, religion, national reputed company, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. Apply tot his job Apply To this Job