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 Part A
🕒 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 PART A. • Perform projects or duties as assigned as a Medical Review Specialist. • Conduct in-depth claims analysis utilizing ICD-10-CM, CPT-4, and HCPCS Level II coding principles. • Utilize electronic health information imaging and input medical review decisions by electronic database module. • Utilize Microsoft Office suite and other software templates as associated source input for claims review. • Make clinical judgment decisions based on clinical experience when applicable. • Responsible for review of Medicare Part A claims. • Meeting quality and production standards.
🎯 Requirements
• Must be a Registered Nurse obtained by either a Bachelor's degree – OR - Associate's degree – OR - Diploma in Nursing. • At least four (4) years related experience. • At least three (3) years clinical experience as a Registered Nurse. • 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
• Health insurance • 401(k) matching • Flexible work hours • Paid time off
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