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

NWtramtTVVlSMWhVdzBHSlMybmxIOVoyaEE9PQ==
  • 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,

Similar Jobs

AppleOne

Document Control and Compliance Specialist Job at AppleOne

 .... Strong organizational skills, attention to detail, and ability to handle confidential information. Proficient in Microsoft Office Suite and quality management tools. ?? What We Offer: Competitive salary and benefits Training and development opportunities... 

Wheeler Staffing Partners

Part Time Office Assistant Job at Wheeler Staffing Partners

 ...especially through acquisitionswere looking for a reliable, detail-oriented professional to help manage the day-to-day needs of a dynamic office environment. This is a great opportunity for someone who enjoys keeping things organized, is comfortable wearing multiple hats,... 

r.World | Reuse

Box Truck Delivery Driver/ Warehouse Worker Job at r.World | Reuse

 ...a reliable, organized, and safety-conscious Delivery Driver/ Warehouse Worker to join our dynamic team in D.C. This role breakdown...  ...communication and interpersonal skills. ~ Availability to work weekends, holidays, and flexible schedules. ~ Attention to detail and... 

Abundant-Minds

Work from Home Education Consultant - Growth Opportunity Job at Abundant-Minds

 ...Flexibility and Autonomy in Self Employment**100% Work Remotely / From Home - Flexible Schedule - Self Employment Our business...  ...level of growth and passionate about Self Improvement / Self Education. OUR BUSINESS AND PASSION We operate in the... 

Community Health Systems

PACS Administrator Job at Community Health Systems

Job DescriptionJob SummaryThe PACS Administrator manages the Picture Archiving and Communication System (PACS) to ensure seamless operation, maintenance, and accessibility of medical imaging within the healthcare facility. This role supports clinical teams by maintaining...