Empower AI
501 - 1000 employees
Founded 1989
Empower AI helps federal agency leaders elevate their workforce productivity. We leverage deep technical expertise and decades of experience solving complex challenges in Civilian and Defense missions to ensure America’s missions are met. Our solutions give government leaders a direct path to meaningful transformation, equipping them with the insights and tools necessary to make critical decisions faster and move their missions forward.
Medical Reviewer III, Medicare/DME
🕒 May 28
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Empower AI
501 - 1000 employees
Founded 1989
Empower AI helps federal agency leaders elevate their workforce productivity. We leverage deep technical expertise and decades of experience solving complex challenges in Civilian and Defense missions to ensure America’s missions are met. Our solutions give government leaders a direct path to meaningful transformation, equipping them with the insights and tools necessary to make critical decisions faster and move their missions forward.
📋 Description
• Perform Medicare comprehensive medical record and claims review to make payment determinations for Medicare Durable Medical Equipment (DME) • Perform projects or duties as assigned as a Medical Review Specialist • You will serve as a critical component in meeting our mission of providing excellent services to our clients • Make clinical judgment decisions based on clinical experience when applicable • Responsible for review of Medicare DME claims • Meeting quality and production standards • Ensuring departmental compliance with quality management system and ISO requirements
🎯 Requirements
• Registered Nurse obtained by either a Bachelor's degree – OR - Associate's degree – OR - Diploma in Nursing • At least four (4) years claims knowledge either from billing, reviewing, or processing of Durable Medical Equipment • At least three (3) years clinical experience as a Registered Nurse • Minimum two (2) years federal and local policy applications in relation to Medicare insurance procedures for medical necessity for Physician Office practices, Laboratory, and Ambulance Services • Current licensure as a Registered Nurse in one or more of the 50 states or D.C. • Ability to keep sensitive and confidential material private • Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program and must have no conflict of interest (COI)
🏖️ Benefits
• Empower AI is proud to be recognized as a 2024 Military Friendly Employer • Supports active-duty and veteran employees
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