We are looking for an experienced Medical Review Manager with expertise in Medicare Fee for Service payment accuracy reviews. As the Medical Review (MR) Manager, you will play a crucial role in ensuring adherence to the MR function of our organization. This is a full-time, remote position.
Key Responsibilities
Overseeing Medicare Fee for Service payment accuracy reviews.
Directly communicating with the Program Director and providing technical assistance to CMS and staff when necessary.
Requirements
Minimum of three years of experience as a Registered Nurse.
Minimum of three years of supervisory/managerial experience in health insurance, utilization review, or healthcare claims processing involving medical and coding reviews.
Extensive knowledge of Medicare program coverage and payment rules.
Education, Licensure, And Certification
Bachelor's Degree in Nursing.
Current Registered Nurse Licensure.
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) Certification, or coding knowledge with active enrollment in CPC/CCS certification course to be completed within twelve months.
We are committed to equal employment opportunity. Applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
Employment Type: Full-Time
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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