Job Summary
A healthcare solution is searching for a person to fill their position for a Remote Clerical Redetermination Examiner.
Candidates will be responsible for the following:
- Conducting redetermination reviews per Medicare rules and regulations
- Researching and identifying claims processing deficiencies and initiates corrective response
- Maintaining knowledge of CMS and Joint Operating Agreement (JOA) requirements
Qualifications for this position include:
- High School diploma or GED
- 6 months' work related experience
- 1-year redetermination processing experience
- Knowledge of medical terminology, CPT, HCPCS and ICD coding