Job Summary
An information technology company is searching for a person to fill their position for a Remote Medical Reviewer V.
Candidates will be responsible for the following:
- Auditing and analyzing sampled Medicaid and CHIP claims
- Serving as a resource for medical review specialists involving coverage, coding, and medical audit issues
- Making determination of the claim's medical appropriateness utilizing clinical review judgment
Skills and Requirements Include:
- 10-15 years experience
- Excellent oral and written communication skills
- Organization and time management skills
- At least four (4) years of clinical experience in medical or surgical nursing
- At least two (2) years of formal management experience
- At least four (4) years of medical record audit experience
