Senior Medical Review Coordinator

2 weeks ago


Rockville, Maryland, United States Hendall Inc Full time
Position Overview

SUMMARY

Hendall Inc. is in search of a qualified Senior Medical Review Coordinator to oversee Medicare claims evaluations for payment accuracy assessments. The ideal candidate will possess a comprehensive understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding standards, while leading a team of nursing reviewers in making informed payment accuracy assessments. The Senior Medical Review Coordinator is tasked with conducting second-level claim evaluations and providing direction and support to the review team.

This role will contribute to the mission of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), which is committed to enhancing health equity, broadening coverage, and improving health outcomes for the community.

The Senior Medical Review Coordinator should meet the following qualifications:

  • Registered Nurse with a bachelor's degree, associate degree, or diploma in nursing
  • A minimum of four years of clinical experience
  • Current licensure in one or more states
  • At least one year of experience supervising medical review teams to uphold quality and productivity standards
  • A minimum of four years' experience applying coverage determinations and relevant policies to Medicare claims as a medical review nurse
  • No pending or completed adverse actions by 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.



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