FULL TIME STAFF MEMBER
National Medical Reviews, Inc. (NMR) is a URAC accredited Independent Review Organization. NMR’s mission is to provide high-quality, objective, independent and expedient medical review services.
The core business of NMR is providing independent medical reviews for all types of benefit disputes and quality of care issues in both the medical management and workers’ compensation settings. NMR provides expedient, unbiased, and expert opinions in a full range of utilization review services for both medical/surgical and behavioral health coverage addressing adverse determinations at the first, second and third level of review, as well as initial determinations.
These reviews include issues pertaining to medical necessity, experimental / investigational, administrative and quality of care concerns (for fraud, waste and abuse).
Position 1: Clinical Nurse Review Coordinator
Is work-life balance and expanding your clinical knowledge important to you?
If you are interested in having your nights, weekends and holidays back – National Medical Reviews, Inc. (NMR) is looking for a licensed LPN or RN for a full time salaried position Monday thru Friday for medical record review.
The role of the Nurse Review Coordinator (RC) is to coordinate the case review process. The RC will work with our administrative staff and panel of physician peer reviewers to answer the questions posed by our clients. The RC is responsible for the quality review of the physician's report. We need your clinical knowledge – do not worry about the process. We will teach you that!
NMR goes beyond the industry standard for the review services. Each NMR client is assigned a primary Review Coordinator (RC) who is a licensed registered nursing professional. The RC provides clinically based account management and plays an integral role in the processing of cases. NMR’s account management philosophy is to provide comprehensive coverage with a clinical focus. While our nurses are the first line of contact, they are fully supported by in-house Chief Medical Director, legal, administrative, and account management professionals.
Main Office: Warminster, PA – prefer candidates in the Philadelphia tri county area
*willing to discuss full time remote with out of state candidates
Responsibilities:
- Collaborate telephonically and electronically with industry professionals (case managers, appeals coordinators, physician reviewers etc.)
- Summarize and produce well-written reports
- Interact with clients and resources throughout the United States
- Coordinate with non clinical administrative support staff to ensure quality and strict timelines are maintained
Requirements:
- Utilization Review / Utilization Management experience
- Broad clinical background
- Excellent written and verbal communication skills
- Computer proficiency using Microsoft Office (Word, Excel, Access)
- Highly organized
- Sharp attention to detail
- Education & Background
- Current Nursing License
- A minimum of five (5) years of clinical experience involving direct patient care
Position 2: Review Coordinator Assistant
Currently, NMR is seeking an administrative assistant to work as a Review Coordinator Assistant (RCA) in the Medical Management Department.
This position is responsible for initiating the case review process, preparing a high quality, completed packet of appropriate case review information. Review Coordinator administrative Assistant will have daily contact with clients and reviewers. Position will also include other administrative duties.
Requirements:
- Excellent written and verbal communication skills
- Personal computer literacy and high competency in the use of Microsoft Office Suite
- Strong organization skills and attention to detail
- Medical terminology, Medical Coding or Billing experience
- High School diploma or equivalent
- Exceptional customer service skills
- Background in Medical Coding and Billing a plus
We provide a supportive, team-oriented work environment with an ongoing mentoring process. Training on medical records review and appeals procedures is provided.
Job Type: Full-time
Please apply below
NMR provides equal opportunity in all of our employment practices to all qualified employees and applicants without regard to race, color, religion, gender, national origin, age, disability, marital status, military status, genetic information or any other category protected by federal, state and local laws.