Independent Review Specialist
Job Summary
To support IDR/IIDR case review processes, the contingent Independent Review Specialist will complete independent dispute resolution reviews in compliance with CMS and URAC standards, working remotely and available for up to 10 hours per week based on business needs.
Key Responsibilities
- Complete IDR/IIDR case reviews in accordance with contract requirements and deadlines
- Manage assigned deliverables, ensuring accuracy, quality, and timeliness
- Perform accurate and timely data entry into CMS systems and internal databases
Required Qualifications
- Experience in long-term care, assisted living, or related healthcare settings
- Knowledge of state and federal regulations governing healthcare facilities and services
- Bachelor's degree or equivalent experience in utilization review, case management, or healthcare field required
- Background in nursing, social work, or CMS surveyor training is highly desirable
- Experience with utilization review or healthcare review processes preferred
Complete Job Description
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