Virginia, 23947
Job description
**Job Title: Nurse Reviewer**
The Nurse Reviewer is responsible for conducting in-depth evaluations of medical records related to Medicare claims to assess their medical necessity and coverage compliance. The role involves documenting well-supported justifications for reimbursement decisions and spotting possible instances of fraud, waste, or abuse. Applicants must possess an active, unrestricted Registered Nurse (RN) license and have 2 to 4 years of clinical experience. A strong understanding of CMS coverage policies and medical documentation standards is essential for success in this position.
STEMHUNTER is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, sexual orientation, gender identity, and gender expression), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law. We comply with all applicable equal employment opportunity and affirmative action regulations.
