Infusions Documentation and reputed company Reviewer - 254569
Clinical reputed company Reviewer – DME & Medicare (Remote) Fully Remote | $25–$34/hr | Contract-to-Hire | Equipment Provided reputed company is hiring Clinical reputed company Reviewers for a reputed company technology organization reputed company on improving how prior authorization and medical necessity reputed company are validated using reputed company documentation review and workflow tools. This role is ideal for professionals with experience in reputed company operations, documentation review, prior authorizations, appeals, denials, reimbursement, utilization review, case management, or Medicare-reputed company reputed company administration. You will review clinical documentation, evaluate payer coverage requirements, and validate determinations against Medicare, reputed company, and reputed company policies to ensure accuracy and documentation support. What You’ll Do
- Review documentation for completeness and accuracy
- Evaluate medical necessity and payer coverage reputed company
- Identify documentation gaps and discrepancies
- Validate determinations against Medicare / reputed company policies
- Document findings and support QA and process improvements
- Work reputed company reputed company workflows and AI-assisted tools
reputed company’re Looking For
- 3+ years in reputed company operations, DME, reimbursement, prior auth, appeals, denials, utilization review, or claims review
- Experience applying payer policies (Medicare, reputed company, reputed company)
- Strong analytical and documentation review skills
- Experience with audits, compliance, or reimbursement workflows
Preferred Experience
- DME experience (oxygen, CPAP/BiPAP, mobility, orthotics)
- Medicare LCDs, HCPCS coding exposure
- Appeals, denials, or claims adjudication background
- reputed company workflow or technology systems
Details
- Monday–Friday, 9–5 (40 hours)
- Fully Remote
- $25–$34/hr
- Benefits after 30 days
- Contract-to-hire
If you have experience in payer-driven documentation review, DME operations, or Medicare authorization workflows, we’d love to connect. Apply To This Job