Role Description We are rapidly expanding our Medical Records Team and are looking for a detail-oriented Records Reviewer to join us immediately. This is a long-term opportunity for professionals with a healthcare background who are passionate about quality, accuracy, and innovation. As a Records Reviewer, you will serve as the final quality checkpoint before medical records are delivered to clients. You'll work closely with our proprietary AI technology to review, validate, and improve medical summaries, chronologies, and case insights while collaborating with internal teams to continuously enhance our review processes. If you have experience reviewing medical records, strong clinical knowledge, and exceptional attention to detail, we'd love to hear from you. Key Responsibilities - Medical Records Review & Quality Assurance - Perform final quality reviews of completed medical record requests before delivery to clients. - Verify the accuracy, completeness, organization, and consistency of medical records. - Identify missing documents, inconsistencies, clinical errors, and documentation gaps. - Ensure all deliverables meet company quality standards. - AI-Assisted Medical Review - Review and validate AI-generated medical summaries, chronologies, and case insights. - Apply clinical knowledge to refine, correct, and enhance AI-generated outputs. - Ensure summaries accurately reflect the underlying medical documentation. - Issue Identification & Escalation - Detect deficiencies, missing information, or quality concerns within completed requests. - Escalate issues to the appropriate internal teams for timely resolution. - Communicate findings clearly and professionally. - Process Improvement - Provide feedback on AI performance, document processing workflows, and internal review tools. - Collaborate with engineering and product teams to improve AI models and operational processes. - Share observations that help enhance review accuracy and efficiency. Qualifications - Healthcare or Medical Records Experience (Required) - Previous experience reviewing medical records OR a professional healthcare background such as: - Registered Nurse (RN) - Licensed Practical/Vocational Nurse (LPN/LVN) - Medical Assistant - Healthcare Administrator - Medical Records Specialist - Health Information Management (HIM) - Or a similar healthcare-related role - Strong understanding of: - Medical terminology - Clinical documentation - Medical record structures - Healthcare workflows - Technical Skills: - Comfortable working with modern software platforms and AI-powered tools. - Quick learner with the ability to adapt to new technologies. - Strong computer literacy and attention to digital workflows. - Communication Skills: - Excellent written English communication skills. - Ability to write clear, concise, and professional documentation. - Comfortable communicating issues and recommendations to internal teams. - Core Competencies: - Exceptional attention to detail with a commitment to producing high-quality work. - Strong analytical and critical thinking skills to interpret medical information accurately. - Clinical judgment to evaluate the relevance and accuracy of medical events and documentation. - Dependability and accountability with the ability to work independently in a remote environment. - Proactive communication by identifying issues early and collaborating with the team. - Long-term commitment and a desire to grow with our company as we continue to scale our AI and medical review capabilities. How to Apply If you have a healthcare background, experience reviewing medical records, and a passion for quality and accuracy, we'd love to hear from you. Please Apply here: https://operationsarmy.com/application Qualified applicants will be contacted for the next stage of the hiring process.

Role Description Perform automated and complex medical record and claim reviews to make coverage determinations based on applicable Medicare coverage policies and payment rules, coding guidelines, National and Local Coverage Determinations, utilization/practice guidelines, and clinical review judgment. Provides professional assessment, planning, coordination, implementation, and reporting of complex data to support the Recovery Auditor Validation Contract (RVC). Essential Functions - Perform accuracy review of automated and complex Medicare medical record and claims review in accordance with all State and Federal mandated regulations/guidelines. - Perform accuracy reviews as a Special Study requested by CMS. - Document findings for each claim in a clear and concise manner. - Compile a report explaining the claim reviews, including identified patterns, inappropriate determinations, as well as recommendations. - Reasonably determines appropriateness to consult a Subject Matter Expert (SME) for clarification. - Perform medical record reviews in response to RAC disputes/disagrees with the RVC review decisions. - Perform accuracy review of the New Issue Proposal for appropriate regulations, references, policies, and edit parameters. Compile a report of analysis and recommendations to submit to CMS. - Perform New Issue Quality Assurance Review for accuracy of all criteria and references. - Consistently meet or exceed productivity and accuracy standards of 95% minimum IRR established by the customer and/or the Company. - Report problems to the Medical Review Manager (MRM) and Project Manager (PM) regarding unique record or process issues. - Maintain security and confidentiality of medical records and Protected Health Information (PHI) and Personally Identifiable Information (PII). - Consistently meet attendance standards established by the Company and follows the telecommuting policy. - Interact appropriately with peers, co-workers, other Contractors, and the customer, when necessary. Contribute to building a positive team spirit. - On occasions may be asked by the MRM or PM to assist with development of training and/or resource materials. - May be asked to assist with precepting of new Medical Review Nurses (MRNs). - Perform other duties and projects as assigned. Qualifications - Registered Nurse, with a current unobstructed license to practice nursing in the United States. Graduate of a Board approved Registered Nursing program. - A Bachelor’s Degree in Nursing (BSN) or other related field is preferred. - Certification in coding highly preferred. - A minimum of three (3) years clinical experience in an acute care hospital, skilled nursing facility, and/or an office/clinic-based medical practice. - A minimum of three (3) or more years’ experience in medical/utilization medical record review particularly with Medicare and/or Medicaid. - Proficiency in research, interpretation, and application of Medicare, Medicaid, and local healthcare regulations and policies. - Must be proficient in Microsoft Office Suite such as Outlook, Excel and Word. Skills & Abilities - Ability to work independently and maintain an elevated level of concentration. - Capable of consistency, speed, and accuracy of task. - Ability to read, analyze, and interpret physician documentation. - One year or more of utilizing InterQual and/or Milliman guidelines against inpatient services experience is preferred. - Ability to communicate clearly and professionally with all levels of the organization, both written and verbal. - Ability to work well in a remote team environment, to collaborate with others, and interface with team members internal and external to the organization. - Establishes and maintains effective professional relationships with internal and external stakeholders. - Must be able to adapt to organizational change. - Must be proficient in Microsoft Office Suite such as Outlook, Excel, and Word. - Flexibility and ability to plan, prioritize, and execute multiple tasks in a fast-paced environment. - Self-motivated, well-organized, and detail oriented. - Ability to maintain a high level of confidentiality and integrity. Benefits - The annual salary range for this position is $80,000 to $95,000. - Actual compensation will depend on a range of factors, including but not limited to the individual’s skills, experience, qualifications, certifications, location, other business and organizational needs, and applicable employment laws. - RELI Group provides a variety of additional benefits to its employees.

• Ensure clinical documentation meets payer-specific insurance coverage criteria • Perform comprehensive reviews of SLP evaluation reports and related clinical documentation • Evaluate documentation for completeness, accuracy, and medical necessity • Support the funding workflow by ensuring clinical documentation is audit-ready • Collaborate with funding teams to resolve clinical documentation issues • Provide clear, actionable feedback to SLPs to improve report quality • Assist in maintaining and updating payer-specific clinical criteria checklists

Title: RN Oasis Reviewer - Home Health Care - Part Time (4 days per week!) Location: Location: Marlton, New Jersey Job Description: At Virtua Health, we exist for one reason to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Location: Lippincott - 301 Lippincott Drive Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time Type: Part-time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 32 Additional Locations: Job Information: - Location: In-Person, Marlton NJ - Hours: Part Time, 32 hours per week (4 days per week, 8:00a - 4:30p.) - Schedule: Mon, Tues, Thurs, Fri - Weekends/Holidays: Every 6th weekend, 1 holiday per year. - Required Experience: Home Health Care experience. - Preferred Experience: Coding experience; Oasis experience. - JNESO union Summary: Responsible for assessing, diagnosing, planning, implementing, and evaluating patient care through outcome identification and evidence based - practice for the patient in their homes. Coordinates patient care and communicates and collaborates extensively with other members of the healthcare team, patients, patient families and significant others to develop the plan of care. Supervises the Home Health Aide in the home. Promotes delivery of quality care and efficient utilization of agency resources. Position Responsibilities: Conducts comprehensive patient assessments incorporating psychosocial and physiological status as well as health behaviors, compliance with therapeutic regime and technical procedures. Coordinates plan of treatment with the physician through timely and appropriate communication with the physician. Administers, monitors, and documents therapeutic interventions and regimes. Demonstrates complete knowledge of established standards for documentation, use of point of service devise, and time frames for completion. Educates patient and family / significant other regarding disease process, individual care needs, wellness, medications, safety issues, etc. Collaborates with other members of the healthcare team to establish the plan of care. Maintains standard precautions and patient safety principles. Identifies and participates in performance improvement activities. Maintains professional and departmental level competencies. Position Qualifications Required / Experience Required: Must have a valid NJ RN License. Approved licenses must be presented and maintained in accordance with the State of New Jersey Licensing Board. 1 - 2 years recent work experience in a hospital i.e. Med/Surg, E.R., OB/GYN, Peds, MICU, CCU or other specialty units and/or one-year recent community health experience. Broad knowledge of nursing practice and ability to apply specific skills in the home health setting. Required Education: Baccalaureate Degree preferred. Hourly Rate: $44.57 - $60.44 The actual salary/rate will vary based on applicants experience as well as internal equity and alignment with market data. Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies.