Infosys

Registered Nurse

Aguadilla, PR, USA · Full-time

Sponsorship not specifiedDetected 1 day ago

ICD-10CollaborationMicrosoft Office

About the role

The company's integrated IT and BPM solutions approach enables it to unlock business value across industries and service lines, and address business challenges for its clients.
Infosys BPM has 38 delivery centers in 13 countries spread across 5 continents, with 60,966 employees from 104 nationalities, as of September, 2025.

Utilizing innovative business excellence frameworks, ongoing productivity improvements, process reengineering, automation, and cutting-edge technology platforms, Infosys BPM enables its clients to achieve their cost reduction objectives, improve process efficiencies, enhance effectiveness, and deliver superior customer experience.

Current Puerto Rico Registered Nurse valid license
Intermediate to advanced knowledge in using MS Office and ability to learn and use various computer software
Experience in any claim adjudication platform
Prefer knowledge of Workman's Compensation, Medicare, COB, no fault

INFY), provides end-to-end transformative business process management (BPM) services for its clients across the globe.
Infosys BPM also has very robust people practices, as substantiated by the various HR-specific awards it has won over the years.
The company has consistently been ranked among the top employers of choice, on the basis of its industry leading HR best practices.
The company's senior leaders contribute widely to industry forums as BPM strategists.
EOE/Minority/Female/Veteran/Disabled/Sexual Orientation/Gender Identity/National Origin

Responsible for accurate and timely processing of healthcare claim service request and processing claims
Familiar with Medical Policy, Familiar with Clinical service requests, correspondence inquiries and image review
Prep medical records for clinical review
Understand/interpret medical terminology including clinical notes and reports
Able to review medical policies and determine the appropriate claim processing or clinical review process decisions (pay, request additional records, refer for clinical review)
Adept knowledge of verifying member benefits, eligibility verification and medical necessity determination
To apply clinical judgement in lines of applicable guidelines while they provide post service Medical Necessity Determination (MND) reviews for Claim Policy business area led by reputed US Payer organization/s
To work in collaboration with Medical Directors to deliver top quality medical necessity determination services to clients
Past experience in an office/clerical setting in the medical field
Certification in medical coding (CPT, ICD-10
Exposure to Healthcare Claims products (Indemnity, PPO, POS/DA, EPO, HMO)
Prior claims experience in medical coding, case management, cost containment review, medical claim management will be preferred

Infosys BPM Limited, a wholly owned subsidiary of Infosys Limited (NYSE: INFY), provides end-to-end transformative business process management (BPM) services for its clients across the globe.
The company has been consistently ranked among the leading BPM companies globally and has received over 60 awards and recognitions in the last 5 years, from key industry bodies and associations like the Outsourcing Center, SSON, and GSA, among others.
Infosys is an equal opportunity employer, and all qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, spouse of protected veteran, or disability.
Process Specialist-US
Work Location
Aguadilla, PR
State / Region / Province

This listing is sourced directly from Infosys's careers page and normalized into a canonical job model.