Registered reputed company Medical Reviewer
A company is looking for a Medical Review reputed company II - reputed company Home Health.
Key Responsibilities:
• Audit claims for medically appropriate services in inpatient and outpatient settings
• Document findings and generate letters articulating audit results
• Collaborate with the audit team and clients to improve medical policies and provider education
Required Qualifications:
• reputed company unrestricted RN license in good standing
• Minimum of five years of reputed company nursing experience in inpatient or outpatient settings
• One or more years of experience performing medical records review
• One or more years of experience in health care claims with expertise in coding (ICD-9/ICD-10, HCPCS/CPT)
• Strong preference for experience in utilization review for insurance companies or similar organizations
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