Registered Nurse, Reviewer

AMDEX Corp

Registered Nurse reviewing Medicare records and preparing physician-review cases for Avar Consulting’s policy research programs. Supporting audits, quality assurance, and Medicare FFS/MA documentation.

Posted 8/22/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-Level💰 $60,000 - $75,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical decision making for Medicare patients, with a strong focus on quality assurance and compliance with Medicare policies. Proficient in data abstraction and report preparation, ensuring accuracy and timeliness in all review processes.

Highest-signal resume keywords

Clinical Decision MakingMedicare Appeals ProcessingQuality Assurance ActivitiesData AbstractionMS Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Decision MakingData AbstractionQuality AssuranceReport PreparationMedicare Appeals Processing

Soft Skills

CommunicationAttention to Detail

Tools & Technologies

PC-Based Computer SystemMS Office Programs

Certifications & Qualifications

Active Professional Licensure

Industry Keywords

Medicare FFSMedicare AdvantageHealthcare DegreeMedicare QIO Experience

About the role

Key responsibilities & impact

Review medical records
Prepare cases for physician review
Perform desktop non-physician review activities and audit functions
Accurately and timely abstract review-related data and information using appropriate review tools
Communicate with and support physician reviewers by summarizing case facts and issues requiring physician input
Conduct mandatory case review and quality assurance activities stipulated by contracts
Maintain required timeliness and accuracy throughout the review process
Meet production goals
Prepare reports and other documentation with attention to Medicare FFS and Medicare Advantage plan policies

Requirements

What you’ll need

Graduation from an accredited school of nursing
Active professional licensure
Minimum of 2–4 years of experience in clinical decision making relative to Medicare patients
Dedicated home office and reliable internet access for secure viewing of protected health information
General knowledge of a PC-based computer system
Intermediate knowledge of various MS Office programs and ability to learn additional software applications
Only US citizens and permanent residents will be considered
Experience with Medicare Appeals processing / BFCC Medicare Quality Improvement Organization (QIO) core functions is desirable
Healthcare-related degree and professional clinical background with Medicare QIO experience may also qualify

Benefits

Comp & perks

Medical, dental, and vision insurance; base plan employee premiums 100% company paid
Employer-paid life and disability insurance, including STD and LTD
Employee Assistance Plan and employee discounts
11 federal holidays
PTO accrual with carryover
401(k) plan with company match
Flexible Spending Accounts: medical, dependent, and transit
Tuition reimbursement and training assistance