A clinical research firm has a current position open for a Remote Medical Devices Senior Project Manager. Core Responsibilities of this position include: Overseeing all activities related to the execution of complex and/or international clinical trials and programs.
2+ years of acute hospital clinical experience. 4+ years of utilization management experience. Current RN license in Arizona and any other compact states. Knowledge of current standard of medical practices and insurance benefits. Familiarity with Milliman and InterQual guidelines.
Preparing and presenting at Investigator meetings. Assisting with the management of medical device distribution, receipt, use and return. Developing and approving study-specific documents, tools, presentations and processes. Must meet the following requirements for consideration:
Conduct clinical reviews of medical records. Process and/or review claims in a timely manner. Document clinical review findings within case tracking system. Required Skills: RN required, with related clinical review experience. Minimum of 5 years clinical experience.
Abstracting medical record documentation. Ensuring accurate code assignment in support of guidelines. Analyzing, entering and manipulating database. Required Skills: CPC or CCS Certification. 3+ years work experience. 6+ months medical coding and 6 months general clerical experience.
Must be able to: Conduct coding reviews of medical records. Process and/or review claims in a timely manner. Document coding review findings within investigative case tracking system. Required Skills: 3+ years’ experience in coding with primary focus in facility and pro fee coding.
Knowledge of official guidelines for coding and reporting. Knowledge of MS-DRGs and reimbursement methods for Medicare, CHAMPUS, Medicaid, other payers. Familiar with charge master and use of CDM for reference. Knowledge of medical terminology, anatomy, physiology, and pharmacology.
A health management solutions company has a current position open for a Remote HEDIS Medical Record Review Nurse. Candidates will be responsible for the following: Entering record review results into NCQA certified software.
Qualifications Include: High school diploma or equivalent. 3-5 years of experience in medical billing, collections, appeals, legal department and/or contract interpretation. Intermediate Microsoft Word and Excel skills. Ability to coordinate accounts and record detailed information.
Conducting coding reviews of medical records. Processing and/or reviewing claims in a timely manner. Monitoring, tracking, and reporting on all case work. Position Requirements Include: 3+ years’ experience in coding with primary focus in facility and pro fee coding.