State Licensed Medical Review Manager - San Francisco California

Company: VirtualVocations
Location: San Francisco, California
Posted On: 01/30/2025

A company is looking for a Medical Review Manager for Government Services.



Key Responsibilities

Oversee the medical review process and ensure compliance with Federal regulations and policies
Educate and direct personnel on CMS review guidelines and manage the Inter-Rater Reliability process
Act as a subject matter expert on reimbursement methodologies and coordinate activities across stakeholders


Required Qualifications

Bachelor's degree in Nursing or equivalent combination of education and experience
AHIMA/AAPC coding certification (CPC, CPC-H, or CCS) required
Current Registered Nurse (RN) license in the United States or U.S. Territory
Minimum of 5 years of experience in auditing medical records and 3 years of management experience
Proficiency in Microsoft Office and knowledge of Medicare reimbursement methodologies and healthcare coding More...

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