Job Description

As a Nurse RN for Medical Reviewer, you'll play a crucial role in ensuring the integrity of Medicare claims. You'll use your expertise in medical terminology, coding, and regulations to review medical records and identify any potential issues.

What you'll do:

Conduct comprehensive clinical reviews of medical records.
Analyze claims data and identify potential fraud or abuse.
Apply Medicare guidelines to determine appropriate payment coverage.
Prepare detailed investigative reports.
Collaborate with physicians, health professionals, and regulatory agencies.
Provide training and support to other team members.
What we're looking for:

Active Registered Nurse (RN) license.
At least 4 years of experience in utilization/quality assurance review and coding.
In-depth knowledge of medical terminology, ICD-9/10-CM, CPT-4 coding, and Medicare guidelines.
Strong analytical and problem-solving skills.
Excellent communication and interpersonal skills.
Ability to work independently and as part of a team.
Why join us?

Remote work: Enjoy the flexibility and convenience of working from home.
Competitive compensation: Receive a competitive salary and benefits package.
Meaningful work: Contribute to the integrity of the healthcare system.
Opportunity for growth: Advance your career in a dynamic and growing company.
Employment Type: Full-Time
Salary: $ 34.00 Per Hour

Job Tags

Hourly pay, Full time,

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