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

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  • 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,

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