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