Medical Review Nurse Analyst

Job description

Location is on site in Biddeford, ME HP is the world's largest provider of information technology infrastructure, software, services, and solutions to individuals and organizations of all sizes. Ranked 10 on the Fortune 500 list for 2012, HP brings together a portfolio to serve more than 1 billion customers in over 170 countries on six continents. HP invents, engineers, and delivers technology solutions that drive business value, create social value, and improve the lives of our clients. At HP, we live for the big idea, the next great discovery. "Invent" is more than a word: it’s who we are. Our innovations in the key strategic areas of Big Data, Cloud, Mobility, and Security help shape the technology industry. Everything we do, we do to make technology more practical, usable, and valuable to our customers. Are you ready to give your career the boost it deserves? DME MAC NHIC DME MAC has the responsibility for providing services to Medicare beneficiaries and Durable Medical Equipment, Prosthetics, Orthotics and Suppliers (DMEPOS) in DME Jurisdiction A which includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. Position Overview The DME MAC Medical Review Clinician will assist in meeting workload targets for Medical Review while adhering to IOM/PIM guidelines. The clinician will be accountable for the review and evaluation of medical records to determine if Medicare claims were filed and/or paid appropriately in an effort to support medical review objectives and for proper medical payments. The clinician will also be responsible to handle requests for advance determinations of medical coverage.