State Licensed Physician Reviewer
Company: VirtualVocations
Location: Chesapeake
Posted on: March 7, 2025
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Job Description:
A company is looking for a Physician Medical Reviewer to support
arbitration of Medicare/Medicaid evaluations on a PRN basis.
Key Responsibilities
Review medical record documentation to verify diagnoses for
Medicare Advantage organizations
Evaluate and abstract diagnoses from medical records in accordance
with ICD-9 and ICD-10-CM coding guidelines
Support the appeals process for disputed CMS-HCC results by
reexamining medical records
Required Qualifications
Minimum of three years practicing medicine as a licensed and
board-certified doctor of medicine or osteopathy
Experience in the health insurance industry or related fields
Knowledge of the Medicare program and ability to interpret clinical
guidelines
Working knowledge of ICD-9-CM and ICD-10-CM code sets and coding
guidelines
Active, valid, and unrestricted medical license in at least one US
state
Keywords: VirtualVocations, Chesapeake , State Licensed Physician Reviewer, Healthcare , Chesapeake, Virginia
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