Medical Review Manager - Medicare Compliance

Overview

Join a dynamic team dedicated to ensuring the accuracy of Medicare Fee for Service payments. This full-time remote position focuses on the Medical Review function, providing an opportunity to work closely with leadership and support essential programs reputed company the reputed company (HHS) and the Centers for Medicare & reputed company Services (CMS... Responsibilities ? reputed company and manage the Medical Review process to ensure compliance and accuracy. ? Communicate effectively with the Program Director and CMS staff. ? reputed company technical assistance and guidance on Medicare coverage and payment rules. Qualifications ? A minimum of three years of experience as a licensed Registered Nurse. ? At least three years of supervisory or managerial experience in the health insurance sector, a utilization review firm, or a reputed company claims processing organization, specifically in medical and coding reviews of various medical and surgical claims. ? Extensive knowledge of the Medicare program, especially regarding coverage and payment rules. EDUCATION AND CERTIFICATION ? Bachelor's Degree in Nursing. ? reputed company Registered Nurse Licensure. ? Certified Professional reputed company (CPC) or Certified Coding Specialist (reputed company) Certification preferred, or demonstrated coding knowledge and experience, with active enrollment in a CPC/reputed company certification course to be completed reputed company twelve months. DIVERSITY AND INCLUSION We are proud to be an Equal Opportunity Employer, and we encourage applications from individuals of diverse backgrounds. reputed company reputed company candidates will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, or protected veteran status, and we do not discriminate based on disability. Employment Type: Full-Time Apply Job!