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 within the Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS...
Responsibilities
? Oversee and manage the Medical Review process to ensure compliance and accuracy.
? Communicate effectively with the Program Director and CMS staff.
? Provide 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 healthcare 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.
? Current Registered Nurse Licensure.
? Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) Certification preferred, or demonstrated coding knowledge and experience, with active enrollment in a CPC/CCS certification course to be completed within twelve months.
DIVERSITY AND INCLUSION
We are proud to be an Equal Opportunity Employer, and we encourage applications from individuals of diverse backgrounds. All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status, and we do not discriminate based on disability.
Employment Type: Full-Time
Similar Remote Jobs
Medical Review Manager - Medicare Compliance
Posted on: 28-08-2024 00:00
Outbound Appointment Specialist (Remote, Night Shift)
Posted on: 28-08-2024 00:00
Digital Assistant - Work From Home
Posted on: 28-08-2024 00:00
Chat Support Specialist - Remote Work
Posted on: 28-08-2024 00:00
Fraud and Payments Associate (Night Shift)
Posted on: 28-08-2024 00:00
Vacation Rentals Expert (Airbnb, HomeAway, Vrbo)
Posted on: 28-08-2024 00:00
Doordash Virtual Assistant Jobs (Part/Full Time)
Posted on: 28-08-2024 00:00
Remote Mortgage Contractor- Due Diligence Required
Posted on: 28-08-2024 00:00
Educational Coordinator -- Remote | WFH
Posted on: 28-08-2024 00:00
Telecommute Medical Transcriptionist. Oklahoma City, OK
Posted on: 28-08-2024 00:00
[!Work AT Home!] Amazon Data Entry Jobs - No Experience Required
Posted on: 18-02-2025 03:59
Online Freelancing - Virtual Assistance
Posted on: 28-10-2024 09:48
Regional Vice President, Sales - East
Posted on: 31-07-2024 19:12
Sr. Tax Accountant or Manager-Great team & Hybrid/Flexible/Perks...
Posted on: 16-07-2024 18:41
Remote/In Person Paralegal - Digital Reporter
Posted on: 17-02-2025 05:59
Engineer - Backend
Posted on: 25-11-2024 05:19
Amazon Customer Service - United States - Work From Home
Posted on: 05-08-2024 00:00
General Manager, Hammes Notre Dame Bookstore?/On-site
Posted on: 16-07-2024 18:56
Exchange Email Engineer II
Posted on: 31-07-2024 19:13
Content Moderator
Posted on: 08-07-2024 05:51