Remote Medical Review Specialist III

Job Summary

An information technology company needs applicants for an opening for a Remote Medical Review Specialist III.

Core Responsibilities Include:

• Performs first and second level of Medical Review in determination of claims payment review
• Conducts in-depth claims analysis utilizing ICD-10-CM, CPT-4, and HCPCS Level II coding principles

Must meet the following requirements for consideration:

• Minimum two (2) years federal and local policy applications
• At least four (4) years clinical experience as a Registered Nurse
• Current licensure as a Registered Nurse in one or more of the 50 states or DC