RN Senior Medical Reviewer
Broadway Ventures
7d
About The Position
The RN Senior Medical Reviewer provides advanced medical review expertise and supports oversight of the medical review process, focusing on complex services and quality assurance.
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
Responsibilities
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
51-100 employees
