Hoveround Corporation Hiring for Medical Records Nurse Reviewer at Bradenton, FL Full Time

POSITION SUMMARY:

Reviews medical forms indicating medical necessity for Durable Medical Equipment. Makes determination of medical necessity based on documentation provided and instructs Case Managers on re-evaluation needs and completing scripts.

ESSENTIAL FUNCTIONS:

• Assists Case Managers with medical review of documentation to determine medical necessity for obtaining DME.
• Audits client cases to ensure quality of department output.
• Works closely with Medical Records and AR Depts. To ensure correct documentation is obtained in order to correctly bill.
• Helps administer and review facsimiles received.
• Performs the function of a Completer, as back up.
• Accurately documents re-evaluation needs in CRM, as well as communicates verbally to Case Manager in a timely manner.
• Serves as an educational resource for medical diagnoses qualifications.
• Assists with and/or conducts periodic medical training, as requested by Manager.
• Assumes other special duties and responsibilities as assigned by Manager.
• Works a minimum of (2) late shifts per week, as well as an occasional Saturday, unless determined otherwise by department manager.
• Works minimum 40-hour work week with required overtime as business needs dictate. (1 late night and 1 Saturday a month)
• Assists with advanced seating needs.

JOB QUALIFICATIONS:

Education/Experience/Technical Requirements

• Nursing degree required. (LPN, RN, PT, or OT)
• Minimum of 5 years’ experience in the medical field.
• Knowledge of ICD-10 coding as it relates to disease process.
• Extensive knowledge of medical terminology.
• Excellent written and verbal communication skills.
• Able to work independently with minimal supervision.

PHYSICAL DEMANDS & WORK ENVIRONMENT:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands:

While performing the duties of this job, the employee frequently sits, uses hand to finger motion, handles or feels objects, reaches with hands and arms, stands, walks and talks. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Bradenton, FL 34203: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Medical records: 1 year (Preferred)

Work Location: In person