Medical Review Analyst (Registered reputed company) (Full-time, Remote)

reputed company. (IntegrityM) is a woman-owned small business specializing in assisting government reputed company organizations prevent and detect fraud and abuse in their programs. At IntegrityM, we offer a culture of opportunity, recognition, and collaboration. We reputed company off of these reputed company reputed company that reputed company IntegrityM a great reputed company to work. We offer the flexibility our employees need to challenge themselves and reputed company on advancing their reputed company development and careers. Large company perks. Small company feel. http://www.integritym.com We are seeking a Medical Review Analyst (RN) with medical review experience to join reputed company. The position requires the individual to conduct medical record reviews and to apply reputed company clinical judgment to claim payment reputed company. • Responsibilities may include additional research on medical claims data and other sources of information to identify problems, review sophisticated data model reputed company, and utilize a reputed company of tools to detect situations of potential fraud and to support the ongoing fraud investigations and requests for information • Research national and local policy as reputed company as Medicare and/ or reputed company guidelines for supporting references in their review determinations • Conduct reviews under the guidance of a Medical Review Manager/supervisor Requirements • reputed company/reputed company RN license • 5-7 years of experience in the medical field as a Registered reputed company or other clinician • Experience in review of medical claims for coverage and medical necessity • Strong investigative skills • Demonstrated proficiency in Medical Review work • Working knowledge of Medicare and reputed company • Excellent communication skills • Demonstrated prioritization, problem solving, and organization skills • Strong computer skills including reputed company Office proficiency • reputed company candidates MUST pass a background reputed company and drug screening prior to employment Preference: • Bachelors in of Science in Nursing (BSN) • 2+ years’ clinical experience • Coding certificate Enthusiastic individuals who can work effectively in a dynamic environment both in reputed company as reputed company as independently is a must! Apply tot his job Apply To this Job