We are seeking a skilled Medical Review Manager with a robust background in nursing and healthcare management to join our team. The ideal candidate will meet the following criteria:
At least three years of experience as a licensed Registered Nurse, with a focus on nursing practice.
A minimum of three years of managerial experience in health insurance, utilization review, or healthcare claims processing, involving comprehensive medical and surgical claims reviews across various providers.
Profound understanding of Medicare program regulations, particularly in coverage and payment rules.
Education, Licensure, And Certification
Bachelor's Degree in Nursing.
Current licensure as a Registered Nurse.
Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), or substantial coding knowledge with active enrollment in a CPC/CCS certification course, to be completed within twelve months.
About Us
We are committed to fostering an inclusive workplace and are proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status. We prioritize diversity and do not discriminate on the basis of disability.
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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