**Job Title: Medicare Fee-for-Service Claims Reviewer**
Conduct thorough evaluations of Medicare Fee-for-Service claims to verify payment accuracy and adherence to CMS regulations. Record observations, engage in dispute resolution processes, and assist in quality assurance through audits and educational initiatives. Applicants must possess a current Registered Nurse license alongside a Medical Coding Certification, such as CPC or CCS. A minimum of 5 years’ experience in medical coding or billing is required, along with at least 3 years in a claims environment focused on productivity.
