Noridian
Medical Review Analyst - REMOTE
This job is now closed
Job Description
- Req#: MEDIC004492
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Salary up to $27.25
- Incentive Plan
- $50/month Lifestyle Benefit
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Open Office Setting
What to Expect (Job Responsibilities):
- Conducts data analysis of reports to determine edits and program effectiveness and acts as the medical review liaison during times of audit activities
- Follows the Progressive Corrective Action (PCA) principles set forth in the Internet Only Manual (IOM) and ensures all statement of work (SOW) requirements are being met
- Reviews and analyzes analytics to determine high-risk services or providers
- Takes progressive corrective actions based on the follow-up data analysis to improve provider error rates
- Coordinates activities, updates process, maintains PTS/cases, and conducts reporting for medical review case management
What is Required (Qualifications):
- 2 years' college education in Business, Medical Administration, Case Management, or related field OR 2 years of Medicare experience
- Advanced PC skills including proficiency in Microsoft Office Suite applications (Word, Excel, Outlook, and PowerPoint)
- Strong verbal and written communication skills
- In-depth knowledge and experience with medical review program requirements, processing systems, and edits and case management activities
- Experience in reporting and analyzing data
How to Stand Out (Preferred Qualifications):
- Experience working with medical review and case management activities
- Experience working with system edits and analyzing and interpreting data
#HealthcareServices #CareerOpportunity #CompetitivePay #IncentivePlan #WorkLifeBalance
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Noridian delivers the most dependable program administration to Center for Medicare & Medicaid Services, State Medicaid and Veterans Administration.
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