State Licensed Medical Review Manager

Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Mon, Jan 27, 2025
This job expires in: 19 days

Job Summary

A company is looking for a Medical Review Manager for Government Services.

Key Responsibilities
  • Oversee the medical review process and ensure compliance with Federal regulations and policies
  • Educate and direct personnel on CMS review guidelines and manage the Inter-Rater Reliability process
  • Act as a subject matter expert on reimbursement methodologies and coordinate activities across stakeholders

Required Qualifications
  • Bachelor's degree in Nursing or equivalent combination of education and experience
  • AHIMA/AAPC coding certification (CPC, CPC-H, or CCS) required
  • Current Registered Nurse (RN) license in the United States or U.S. Territory
  • Minimum of 5 years of experience in auditing medical records and 3 years of management experience
  • Proficiency in Microsoft Office and knowledge of Medicare reimbursement methodologies and healthcare coding

COMPLETE JOB DESCRIPTION

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