CoventBridge Group
2 open remote positions
(2 of 2 jobs with salary data)
Salary Distribution✨ Benefits Overview (2 of 2 jobs list additional benefits)
The Medicare Medical Review RN will primarily be responsible for conducting clinical reviews of medical records during the course of fraud investigations. This position applies Medicare and Medicaid guidelines in making clinical determinations as to the appropriateness of payment coverage. You will be a critical contributor to improved healthcare delivery.
Performs evaluation and development of leads, complaints, and/or investigations to verify allegations of potential fraud. Recommends and/or implements appropriate administrative actions. Will be a critical contributor to meeting CoventBridge Group's objective: To provide services to our clients that exceed their expectations. Conducts independent reviews resulting from the discovery of situations that potentially involve fraud or abuse.