What are the responsibilities and job description for the Medical Review Specialist position at TalentBridge?
Pay Rate : $23 / hourFully RemoteQualifications : Current unrestricted Licensed Practical Nurse (LPN) license with long-term care experience (mandatory).Minimum 2 years of clinical experience (required).Experience performing medical review for all DMEPOS categories within Medicare (required).Knowledge of CMS Internet Only Manuals and Medicare LCD / LCA requirements (preferred).Prior experience with MAC, ZPIC / UPIC, RAC, SMRC, or QIC (preferred).Essential Duties and Responsibilities : Review documentation and apply Medicare coverage criteria to adjudicate DMEPOS appeals.Identify and organize medical records, provide written clinical rationales, and ensure timely case reviews.Escalate cases to supervisors, physicians, or related disciplines when necessary.Complete reports and documentation in accordance with contract standards.Meet production and quality standards consistently.Become a subject matter expert (SME) using job aids and tools.Perform assignments requiring judgment and initiative.Apply today to join a dedicated team focused on quality care and compliance!#INDCLT#J-18808-Ljbffr
Salary : $23
