Medical Reviewer II performing medical reviews utilizing clinical information and established guidelines. Supporting insurance claims management and educating staff regarding processes and terminology.
About the role
- Collect and submit reliable data for the National Surgical Quality Improvement Program at UMMC. Work closely with surgery department on clinical quality improvement and data submission.
Responsibilities
- Collect and submit reliable data to the National Surgical Quality Improvement Program (NSQIP)
- Work closely with members of the department of Surgery to identify opportunities for clinical quality improvement
- Identifies surgical patients for inclusion in the program through inclusion criteria and protocols
- Collects preoperative, interoperative, 30-day postoperative, and long-term follow-up data components
- Works effectively with all appropriate hospital and medical center staff necessary for the management and success of the program
Requirements
- Two (2) years' experience in hospital surgery department or surgery clinic
- BSN preferred
- Valid RN license
- Successful NSQIP SCR training/certification within ninety days of hire date
- Knowledge of patient charts, medical terminology, and surgical procedures
- Skill in the use of personal computers and related software applications
- Ability to read and interpret medical terminology
Benefits
- UMMC is an equal opportunity employer
- Provides reasonable modifications to policies for qualified individuals with disabilities
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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