Senior Medical Reviewer
Simsy Ventures
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Assist Medical Review Management with monitoring the medical review process
- Conduct medical record reviews for complex services
- Evaluate compliance with Medicare coverage, coding, and billing rules
- Contribute to medical review and proposal deliverables
- Participate in quality assurance activities to ensure consistency and accuracy
Requirements
- Bachelor of Science in Nursing (BSN)
- Current, active, unencumbered Registered Nurse license in the United States
- Certified Coder credentials required
- Minimum of three (3) years of medical record review experience
- At least three (3) years of current and/or relevant clinical experience
- Two (2) years of quality assurance experience required
- Extensive knowledge of the Medicare program
- Working knowledge of CMS FFS RAC Program requirements and activities
Benefits
- Health insurance
- 401(k) matching
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical record reviewcompliance evaluationcodingbillingquality assuranceclinical experienceMedicare knowledgeCMS FFS RAC Program knowledge
Certifications
Registered Nurse licenseCertified Coder credentials