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Clinical Claims Review Expert
2 months ago
INTRODUCTION
Hendall Inc. is in search of a qualified Clinical Claims Review Expert to conduct evaluations of Medicare claims to ensure payment accuracy. The ideal candidate will possess a comprehensive understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding standards, leveraging their knowledge of Medicare policies and clinical expertise to assess payment accuracy while upholding exceptional standards of review quality and efficiency.
This is a full-time, remote opportunity.
This role will contribute to the mission of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), which is committed to serving the public as a reliable partner and steward, focused on promoting health equity, enhancing coverage, and improving health outcomes.
The Clinical Claims Review Expert should meet the following qualifications:
- Registered Nurse with a bachelor's degree, associate degree, or diploma in nursing
- A minimum of two years of clinical experience
- Current licensure in one or more states
- Experience in applying coverage determinations and relevant policies to Medicare claims as a medical review nurse
- No pending or past adverse actions from any licensure board
Hendall Inc. is an Equal Opportunity Employer. All qualified candidates will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not face discrimination based on disability.
