Remote Independent Medical Reviewer/Pulmonary Disease Job at Maximus Federal, McLean, VA

ODdydmdURTEwL3htQm1jU3djd1l2czVPM1E9PQ==
  • Maximus Federal
  • McLean, VA

Job Description

We are seeking a Medical Review Specialist with experience in pulmonary disease for our Maryland Independent Review Organization (MD IRO-SAE). Join our team to perform Independent Reviews on medical necessity denial disputes for Medicaid beneficiaries.

  • Review and analyze cases to determine medical necessity
  • Utilize tools like Salesforce, ERIC, and InterQual
  • Provide decision write-ups using the IRAC format

This role requires 24 hours of active practice per week, with varying case volumes. If you have a passion for ensuring quality care, apply now!

Job Tags

Full time,

Similar Jobs

Advice Personnel

HR Generalist - Union County Real Estate Firm - $60k-$70k Job at Advice Personnel

 ...HR Generalist Union County Real Estate Firm $60k-$70k A commercial real estate firm in Union County, NJ with approximately...  ...concerns, and HR-related matters. Lead recruitment efforts for entry-level positions (e.g., Accounts Receivable, Accounts Payable),... 

Labcorp

Medical Technologist I Job at Labcorp

 ...less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please click here. Labcorp is proud to be an Equal Opportunity Employer: Labcorp strives for inclusion and belonging in the workforce and does not tolerate... 

Solomon Page

Travel RN - Emergency Dept - $1,827 per week Job at Solomon Page

 ...Effective communication skills, including active listening, writing, speaking and reading comprehension Fast and adaptive problem...  ...comprehensive benefits package, travel nurses have immediate access to medical coverage and ReviveHealth virtual care. Additionally, you are... 

Red Bull

Distributor Partner Manager Job at Red Bull

 ...value-added partner ensuring full alignment and focus to drive execution across RedBull North Americas (RBNA) Distribution Network (DPs). The DPM brings value through year-round business planning, driving in market execution, ensuring implementation of regional &... 

Right Discovery

eDiscovery Project Manager Job at Right Discovery

 ...Overview The eDiscovery Project Manager role is responsible for high level management, delegation, and execution of day-to-day e-discovery project tasks. The role involves concurrently managing multiple projects of varying complexity. The incumbent will collaborate...