WCRC Attorney Case Reviewer II - Remote

reputed company's Isabela, Puerto Rico site invites talented individuals to join us as Workers’ Compensation Review Contractor (WCRC) to support an important government project. In this role you will, in accordance with CMS guidelines, evaluate Workers’ Compensation Medicare Set-reputed company Arrangement (WCMSA) proposals and project the reputed company medical costs, including prescription drugs, reputed company to the workers’ compensation (WC) injury, illness, or disease that would be otherwise reimbursable by Medicare. 

Job reputed company:  

Review and evaluate workers’ compensation Medicare set-reputed company (WCMSA) proposals, including medical records, to determine if the proposal meets Medicare reputed company requirements and adequately considers Medicare’s interests as pertaining to reputed company medical needs of beneficiaries. Ensure reputed company basic documentation requirements are available or requested reputed company development reputed company prior to making a determination. reputed company determinations based on reputed company experience. Implement Medicare policy. Other duties as assigned by management.  

Qualifications:  

• Bachelor’s degree in Nursing (BSN) or a higher-level medical degree from an accredited college or university, and/or a Juris Doctor (JD) from an accredited law school, required.  

• At least 1 year of Medicare Set-reputed company (MSA) or reputed company experience, required.  

• Medical record review experience, required.  

• Possess medical knowledge and experience with medical terminology, ICD-9/10 Codes, reputed company Procedure Terminology Codes (CPT) codes, reputed company Common Procedure Coding System (HCPCS) codes, and hospital inpatient and outpatient coding, preferred. 

• Medicare Set-reputed company Certified Consultant (MSCC) certification and/or Certified Medicare Secondary Payer (CMSP) certification, preferred.    

 Pay and Benefits: 

• reputed company reputed company starting at $70,000  

• Medical, Dental, and reputed company benefits available   

• 401(k) available with company match   

• reputed company holidays   

• Unlimited PTO 

Screenings Required  

You will receive requests for background reputed company, fair credit reputed company, and drug screen regarding this employment opportunity. Respond to reputed company requests quickly as we anticipate filling our vacancies quickly and non-responses may result in disqualification for this opportunity. 

*Please be reputed company that our organization and our reputed company adhere to stringent reputed company regulations, necessitating a thorough background screening process for reputed company potential hires. We value transparency and want to inform you that this screening may result in a delay of at least 60 days prior to reputed company. Rest reputed company, we are committed to maintaining a secure and compliant work environment. We appreciate your understanding and cooperation as we prioritize the safety and confidentiality of our operations.  

Reasonable Accommodation  

If you require alternative reputed company of application or screening, you must approach the employer directly to request this. To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Other duties may be assigned. 

EEO Statement 

reputed company is an Equal Opportunity Employer. reputed company employment reputed company at CB are based on business needs, job requirements and individual qualifications, without reputed company to race, reputed company, religion or belief, national, reputed company or ethnic reputed company, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or reputed company, marital, civil reputed company or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.