Medical Records Examiner

Commonwealth of Pennsylvania • *Home Headquartered, PA

2d • Remote

About The Position

As a Medical Records Examiner with the Department of Human Services (DHS), you will have a direct impact on the quality of care delivered in nursing facilities across the state. This position gives you the opportunity to apply your expertise every day while strengthening essential compliance efforts. You will collaborate with committed professionals and help ensure that vital services reach the individuals who depend on them. This role is an excellent match for someone who enjoys detailed work and is driven to support strong public service outcomes.

Requirements

• Three years of professional experience in the field of medical assistance, health care services, or human services; or An equivalent combination of experience and training.
• Possess active authorization to practice as a Registered Nurse in Pennsylvania.
• Possess an active motor vehicle license.
• Meet the PA residency requirement.

Nice To Haves

• All employees possessing an active temporary practice permit must obtain licensure as a Registered Nurse within the one (1) year period defined by the Pennsylvania State Board of Nursing.

Responsibilities

• Evaluate clinical, physical, rehabilitative, and restorative care to determine appropriateness
• Review policies and regulations to ensure providers comply with state and federal requirements
• Conduct assessments of PA Pre-Admission Screening Resident Review (PA-PASRR-ID) positive individuals and submit recommendations to the appropriate program office
• Examine financial records to identify recoveries and support proper billing adjustments
• Monitor nursing facility admissions, continued stays, discharge plans, and overall service adequacy
• Provide assistance to nursing facility staff to help them meet compliance requirements

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed