Location: Remote
Pay Rate: ***
Hours; 8:30 am – 5:00 pm (Monday – Friday)
Title: QIC Part A Nurse Consultant
Job Description
Essential Duties and Responsibilities:
– Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations.
– Render medical necessity determinations for Medicare State East cases assigned.
– Resolve all other technical issues within Medicare reconsideration assigned.
– Review cases to determine and summarize facts of each case assigned and assesses issues involved in the case.
– Perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
– Perform other duties as assigned by management.
Minimum Requirements:
– Bachelor’s degree with 3-5 years of experience consulting within designated function.