Job Description
Medical Review Specialist
Fundamental Clinical Consulting, LLC, is seeking a talented Medical Review Specialist to provide consultation and support to a number of our skilled nursing facilities to ensure medical records are complete and accurately coded.
About the Opportunity
Responsible for reviewing medical records prior to submission to fiscal intermediary as appropriate. Responsible for providing support, training, and education to assigned facilities on proper claim coding and documentation requirements. Also provides guidance for Interdisciplinary team meetings, Claim Triple Check and Claims Denial Management protocols. Assists facilities with interpreting Medicare Additional Development Requests (ADRs) and Appeals and helps to respond to requests according to Company policy. Communicates regularly with Administrator, DON, facility personnel, including therapy department on daily basis and provides recommendations/suggestions on process improvement. Maintains current knowledge of medical record requirements in accordance with regulations. Responsible for assisting assigned facilities to comply with appropriate state, federal guidelines/regulations, in accordance with established company policies and procedures.
Benefits
We offer a comprehensive benefit package which includes medical/dental insurance, life insurance, short term and long term disability, Vacation/Holiday/Sick, 401 (k), tuition reimbursement, flexible spending accounts, in-facility education programs and so much more.
Salaries commensurate with experience.
*Equal Opportunity Employer. Drug-free work environment.
www.fundltc.com
Job Requirements
Qualifications
Ideal candidate must be a skilled communicator, director and motivator. Able to organize and prioritize many tasks effectively.
Three to Five years of clinical experience with primary focus in long term care.
Experience in MDS/PPS management, Medicare denials management and medical records management required
Three to Five years experience as an RN, LVN, RPT, OTR or SLP in a long term care setting.
Position will require 50% travel - must be able to travel by air and personal automobile as needed. Some overnight travel will be required.
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