Medical Review II (Medicare)

Position Summary:

• Perform complex medical review of Medicare claims for Inpatient Rehabilitation Facility services.
• Conduct pre-claim review determinations and evaluate Additional Documentation Request responses.
• Communicate determinations to providers and meet production-driven turnaround requirements.

Minimum Qualifications:

• Associate Degree in Nursing or graduate of accredited School of Nursing.
• 2 years clinical experience and active RN licensure.
• Working knowledge of word processing software and ability to work independently.

Preferred Qualifications:

• Bachelor's degree in Nursing preferred.
• 3 years RN clinical experience and knowledge of Medicare regulations.
• Experience with spreadsheet and database software.

Benefits:

• 401(k) with company match, PTO that grows, health, vision, dental insurance.
• Company provided life insurance and short-term/long-term disability.