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, DRG
🕒 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 for DRG claims • 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 internet and intranet sources for policy verification • Responsible for review of Medicare DRG claims • Meet quality and production standards
🎯 Requirements
• Must be a Registered Nurse (Bachelor's degree, Associate's degree, or Diploma in Nursing) • At least four (4) years claims knowledge (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 • 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
• 2024 Military Friendly Employer recognition • Commitment to hiring and supporting active-duty and veteran employees
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