Job Summary
A provider of enterprise solutions is seeking a Remote Medical Review Supervisor.
Core Responsibilities of this position include:
- Developing, approving, implementing and ensuring department compliance
- Performing oversight of appeals reviews initiated by Medicare Advantage Programs
- Ensuring the MR department's compliance with quality management system
Qualifications for this position include:
- Travel by land or air transportation 10%
- Bachelor's Degree or equivalent related experience
- Must be a Certified Professional Coder
- Must be a Registered Nurse with an active license in the state of residence
- Must have no adverse actions pending or taken against him/her by any State or Federal licensing board
- 4 years experience performing medical reviews on patient medical records