Back
USA   USA   Nurse   LE Cyr Consulting -

Nurse Remote Medical Review Specialist | Nurse in Nurse & Healthcare Job at LE Cyr Consulting 1

This listing was posted on The Resumator.

Nurse Remote Medical Review Specialist

Share
Tools
Description:

Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules and regulations. The reviews are performed by specially trained clinical staff using various methods to track the assignment, progress, and resolution of claims/cases. For complex claim reviews, the Companies are required to use Registered Nurses (“RNs”). Clinical decisions will be based on CMS policies/procedures defined in the CMS Internet-Only Manual (IOM), Company policies/procedures, Title XVIII of the Social Security Act (Section 1862), generally accepted standards of medical practice, clinical knowledge, contract guidelines, applicable Code of Federal Regulation guidelines, or other relevant statutory authority as applicable. Our staff will perform this work for Medical Reviews, Appeals, and/or Prior Authorization requests. Qualified Staff and Work Location Requirements A valid RN license in any state and two years of clinical experience Bi-lingual preferred by not a must Associates Degree Preferred background in Home Health or Skilled nursing preferred Must have access to high-speed internet, be provided hardware for processing reviews. be available to perform work within the Company-specified core hours of 9:00 AM – 3:00 PM EST based on system availability. Pay rate between $30-$34 per hour plus benefits Powered by JazzHR
Company:
LE Cyr Consulting
Posted:
January 2 on The Resumator
Visit Our Partner Website
This listing was posted on another website. Click here to open: Go to The Resumator
Important Safety Tips
  • Always meet the employer in person.
  • Avoid sharing sensitive personal and financial information.
  • Avoid employment offers that require a deposit or investment.

To learn more, visit the Safety Center or click here to report this listing.

More About this Listing: Nurse Remote Medical Review Specialist
Nurse Remote Medical Review Specialist is a Nurse & Healthcare Nurse Job at LE Cyr Consulting located in United States. Find other listings like Nurse Remote Medical Review Specialist by searching Oodle for Nurse & Healthcare Nurse Jobs.