Medical Review Specialist

OVERVIEW

Hendall is seeking an experienced Medical Review Specialist to perform Medicare claims review for payment accuracy determinations. The successful candidate will have a knowledge and understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding principles, and utilize Medicare policy knowledge and clinical experience to make payment accuracy determinations while maintaining a high level of review quality and production. Please note this is a full-time, remote position.

This position will support Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) which serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes.

The Medical Review Specialist shall possess a combination of experience and qualifications meeting the following criteria:

• Registered Nurse with bachelor's degree, associate degree, or diploma in nursing


• At least two years clinical experience


• Current licensure in one or more state


• Experience applying coverage determinations and relevant policy to Medicare claims as a medical review nurse


• No adverse actions pending or taken by any licensure board

Hendall Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.