- Registered Nurse with bachelor's degree, associate degree, or diploma in nursing
- At least four years clinical experience
- Current licensure in one or more state
- At least 1 year experience supervising medical review teams to ensure quality and production standards
- At least 4 years' experience applying coverage determinations and relevant policy to Medicare claims as a medical review nurse
- No adverse actions pending or taken by any licensure board
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Medical Review Specialist
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Lead Medical Review Specialist
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Hendall, Inc. Rockville, United StatesHendall is seeking an experienced Lead Medical Review Specialist to perform Medicare claims review for payment accuracy determinations. The successful candidate will have a knowledge and understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding pr Medical, Specialist, Lead, Ma ...
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Lead Medical Review Specialist
2 weeks ago
Hendall Inc. Rockville, United StatesOVERVIEW · Hendall is seeking an experienced Lead Medical Review Specialist to perform Medicare claims review for payment accuracy determinations. The successful candidate will have a knowledge and understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding principles, and lead ...
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Medical Review Specialist
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Hendall Inc. Rockville, United StatesOVERVIEW · Hendall is seeking an experienced Medical Review Specialist to perform Medicare claims review for payment accuracy determinations. The successful candidate will have a knowledge and understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding principles, and utilize M ...
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Case Review Specialist
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STG International Rockville, United StatesSTG International is currently seeking a **Case Review Specialist** for Federal Occupational Health Services in Rockville, MD. · Job Specific Duties and Responsibilities: · Provide direct support to the mission of Federal Occupational Health (FOH), a component of the Program Supp ...
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Medical Review Specialist
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Hendall Inc Rockville, United States**OVERVIEW** · The Medical Review Specialist shall possess a combination of experience and qualifications meeting the following criteria: · - Registered Nurse with bachelor's degree, associate degree, or diploma in nursing · - At least two years clinical experience · - Current li ...
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Lead Medical Review Specialist
2 weeks ago
Hendall Inc Rockville, United States**OVERVIEW** · The Lead Medical Review Specialist shall possess a combination of experience and qualifications meeting the following criteria: · - Registered Nurse with bachelor's degree, associate degree, or diploma in nursing · - At least four years clinical experience · - Curr ...
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Utilization Review Specialist
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Washington D.C. Washington, United StatesGeneral Job Information · Job Summary · The incumbent functions as a Utilization Review Specialist in Health Information Management. The Utilization Review Specialist performs studies/reviews of medical records to monitor and to determine that the quality of clients' treatment an ...
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Clinical Review Specialist
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Healthcare Legal Solutions LLC Washington, United StatesJob Description · Job DescriptionDescription · The Clinical Review Specialist is responsible for proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims. Responsibilities include drafting appeal le ...
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Document Review Specialist at Richmond, VA
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Alakaina Family of Companies Frederick, United StatesThe Alaka`ina Foundation Family of Companies (FOCs) is looking for a qualified Senior Biodefense Regulated Quality Review Specialist to support our contract with USAMRIID in Frederick, Maryland. · The candidate shall provide Quality Review (QR) Specialist support, to include 100% ...
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Alaka'ina Foundation Family of Companies Fort Detrick, United StatesSr. Biodefense Regulated Quality Review Specialist · Location MD - Fort Detrick · Job Code 11615 · # of openings 1 · Apply Now ) · The Alaka`ina Foundation Family of Companies (FOCs) is looking for a qualified Senior Biodefense Regulated Quality Review Specialist to support ...
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Fatality Review Program Specialist
2 weeks ago
Office of the Chief Medical Ex Washington, United StatesThis position is located in the D.C. Office of the Chief Medical Examiner (OCME), Fatality Review Unit (FRU). The primary purpose of the position is to plan and coordinate case reviews as required by the assigned fatality review committee. The incumbent is responsible for all act ...
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Sr. Environmental Project Manager/Scientist
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Nuclear Regulatory Commission Rockville, United StatesSummary · This position is located in the Office of Nuclear Material Safety & Safeguards (NMSS), Division of Rulemaking, Environmental & Financial Support (REFS), Environmental Review License Renewal Branch. · The supervisor is Ted Smith · This position is Bargaining Unit with ...
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AML/BSA Analyst
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Eagle Bancorp Inc Rockville, United StatesOverview · We are a values driven organization putting · Relationships FIRST . EagleBank (NASDAQ - EGBN) is focused on being · Flexible, Involved, Responsive, Strong , and · Trusted . By prioritizing meaningful connections with our customers, employees, and shareholders, we r ...
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Exhibits Associate
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Eclaro Rockville, United StatesAs an Exhibits Associate, you will assist with the organization of exhibitions at national and regional conferences, along with other special projects. You will also assist with daily operations, and serve as a liaison with outside institutions, contractors, and departments. · W ...
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Contracts Analyst
2 weeks ago
Global Solutions Network Inc. Rockville, United StatesIf you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.Contracts Analyst - NIH · 8 days ago · Requisition ID: 1567Global Solutions Network (GSN), a federal government contractin ...
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GWAC Management Specialist, Sr Contracts Manager
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IMSolutions, LLC Rockville, United StatesIMSolutions seeks a GWAC Management Specialist to fill an exciting opportunity supporting the federal government. · Thisposition is hybrid – you must be in the Rockville, MD, location once a week. · As a GWAC Management Specialist, you will help administer the CIO-CS Government ...
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Digital Marketing Specialist
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Proposal Strategist
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Cherry Bekaert LLP Rockville, United States Full timeProposal Strategists manage and execute the proposal process for complex Assurance, Tax, and Advisory engagements, managing multiple proposals at once. They utilize exceptional writing, project management and communication skills to develop and ensure on-time delivery of compelli ...
Lead Medical Review Specialist - Rockville, United States - Hendall Inc
Description
Job Description
Job DescriptionOVERVIEW
Hendall is seeking an experienced Lead Medical Review Specialist to perform Medicare claims review for payment accuracy determinations. The successful candidate will have a knowledge and understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding principles, and lead a team of nurse reviewers in make payment accuracy determinations. Lead Medical Review Specialist are responsible for second level claim determinations and providing leadership and guidance to review staff. Please note this is a full-time, remote position.
The Lead Medical Review Specialist shall possess a combination of experience and qualifications meeting the following criteria:
Hendall Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.