Registered Nurse, Reviewer

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $60k - $75k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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AMDEX Corp

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1987

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

AMDEX Corp. is a company dedicated to supporting the U. S. Department of Labor in its mission to enhance the workforce and provide essential services related to employment, safety, and labor regulations. The company focuses on delivering solutions in areas like disaster recovery assistance, health plans and benefits, and the enforcement of workplace safety standards, ensuring that U. S. workers are well-informed and protected in their employment settings.

📋 Description

• Review medical records • Prepare cases for physician review • Perform desktop non-physician review activities and audit functions • Accurately and timely abstract review-related data and information using appropriate review tools • Communicate with and support physician reviewers by summarizing case facts and issues requiring physician input • Conduct mandatory case review and quality assurance activities stipulated by contracts • Maintain required timeliness and accuracy throughout the review process • Meet production goals • Prepare reports and other documentation with attention to Medicare FFS and Medicare Advantage plan policies

🎯 Requirements

• Graduation from an accredited school of nursing • Active professional licensure • Minimum of 2–4 years of experience in clinical decision making relative to Medicare patients • Dedicated home office and reliable internet access for secure viewing of protected health information • General knowledge of a PC-based computer system • Intermediate knowledge of various MS Office programs and ability to learn additional software applications • Only US citizens and permanent residents will be considered • Experience with Medicare Appeals processing / BFCC Medicare Quality Improvement Organization (QIO) core functions is desirable • Healthcare-related degree and professional clinical background with Medicare QIO experience may also qualify

🏖️ Benefits

• Medical, dental, and vision insurance; base plan employee premiums 100% company paid • Employer-paid life and disability insurance, including STD and LTD • Employee Assistance Plan and employee discounts • 11 federal holidays • PTO accrual with carryover • 401(k) plan with company match • Flexible Spending Accounts: medical, dependent, and transit • Tuition reimbursement and training assistance