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
ApexFocusGroup is hiring: Data Entry Clerk Work From Home - Part Time Focus Grou
Posted on: 29-11-2024 08:27
Customer Care Manager - Remote Work
Posted on: 26-12-2024 06:11
Customer Experience & Support PMM
Posted on: 17-09-2024 00:00
Walgreens Near Me Careers, Wfh Data Entry Jobs
Posted on: 22-09-2024 00:00
Patient Engagement Specialist - Central Team (Remote)
Posted on: 20-01-2025 00:00
Sr. Data Engineer - Remote
Posted on: 16-07-2024 18:45
Live Chat Agent-WFH REMOTE
Posted on: 23-02-2025 00:00
Costco Data Entry (Remote, Part/Full Time) $65000/Year
Posted on: 19-02-2025 06:29
(Entry Level/Remote) Apple Support College Program At Home Advisor
Posted on: 16-07-2024 18:59
Operations Engineering Intern (Spring/Summer 2025), Operations Engineering
Posted on: 27-08-2024 00:00