State Licensed Medical Review Manager
Company: VirtualVocations
Location: San Francisco
Posted on: January 29, 2025
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Job Description:
A company is looking for a Medical Review Manager for Government
Services.
Key Responsibilities
Oversee the medical review process and ensure compliance with
Federal regulations and policies
Educate and direct personnel on CMS review guidelines and manage
the Inter-Rater Reliability process
Act as a subject matter expert on reimbursement methodologies and
coordinate activities across stakeholders
Required Qualifications
Bachelor's degree in Nursing or equivalent combination of education
and experience
AHIMA/AAPC coding certification (CPC, CPC-H, or CCS) required
Current Registered Nurse (RN) license in the United States or U.S.
Territory
Minimum of 5 years of experience in auditing medical records and 3
years of management experience
Proficiency in Microsoft Office and knowledge of Medicare
reimbursement methodologies and healthcare coding
Keywords: VirtualVocations, San Jose , State Licensed Medical Review Manager, Executive , San Francisco, California
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