Local Contract Nurse RN - Utilization Review
New Cumberland, PA
A-Line Staffing Solutions
5x7 hrs, Days

NOW HIRING: RN Medicaid Coding & Claims Review Specialist (HYBRID)

Location:Harrisburg, PA (Hybrid Schedule: 2 days in office per week required; 3 days Remote)
Compensation: $40/hour
Shift: Mon-Fri, 8a-4p

Overview:

A-Line Staffing is seeking an experienced Registered Nurse with a background in medical claims review, coding, and healthcare operations to join a growing team supporting Pennsylvania Medicaid programs. This hybrid role offers a flexible schedule with 2 days onsite in Harrisburg and 3 days remote from home.

This position is ideal for an RN who enjoys analytical work, claims review, coding research, process improvement, and collaborating on healthcare operations projects.

Registered Nurse Responsibilities:

• Review, analyze, and process medical claims for accuracy and compliance
• Assist with CPT, HCPCS, and procedure code updates
• Support claims processing operations and coding-related decisions
• Research medical policies, regulations, and reimbursement guidelines
• Participate in operational projects, workgroups, and system improvement initiatives
• Collaborate with leadership, healthcare partners, and external stakeholders
• Assist with process improvements and system enhancements
• Provide operational and analytical support for Pennsylvania Medicaid programs

Registered Nurse Qualifications:

• Active Pennsylvania Registered Nurse (RN) license required
• 5+ years of experience in claims review, medical coding, or claims processing
• Knowledge of CPT, HCPCS II, or dental coding
• Experience with Medicaid, Medicare, or Medical Assistance coding rules
• Familiarity with PROMISe or similar claims processing systems preferred
• Strong Microsoft Office skills, including Excel, Word, and PowerPoint

Registered Nurse Benefits:

• Medical, Dental, and Vision Insurance
• 401(k) with Company Match and Profit Sharing
• 5 Days PTO
• 12 Paid Holidays
• Hybrid Work Schedule
• Stable Full-Time Opportunity

Apply TODAY or Contact Recruiter for next steps:

Alliston Brown | |