CrawlJobs Logo

Medical Reviewer, Surgical Dressings

versemedical.com Logo

Verse Medical

Location Icon

Location:
United States

Category Icon
Category:
-

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

65000.00 - 105000.00 USD / Year

Job Description:

This isn't just a job; it's a chance to build something that matters. As DME Medical Reviewer, you'll be shaping the future of at-home care. You'll be a key part of the team, working to ensure each surgical dressing order is fully compliant with every CMS regulation, including regulation/ policies as they are applied by MACs & UPICs. You’ll translate LCDs/ Articles and MAC playbooks into checklists, fix packet defects pre‑bill, and run our ADRs/appeals processes.

Job Responsibility:

  • Interpret and operationalize LCD L33831 + Policy Article for surgical dressings
  • publish practical rules (when covered, limits, documentation phrases)
  • Stand up “go/no‑go” criteria for collagen, alginate/fiber‑gelling, foam, film, hydrocolloid
  • codify A‑modifier (wound count) usage, KX/GA/GZ/EY, sizing, quantity/frequency math
  • Build a 2‑gate QA (1: clinical completeness
  • 2: billing correctness) and pilot it on all surgical‑dressing claims
  • Create/upgrade templates for various outreach
  • Lead UPIC/MAC ADR responses (pre‑ and post‑pay)
  • Coach internal billing team
  • establish a reusable appeals library with policy citations and exemplars
  • Train customer-facing team members (30‑min modules) and billers on the specific documentation that satisfies the LCD
  • Define and track metrics: initial denial %, appeal win %, ADR turnaround, % packets with signed POD, top‑defect Pareto

Requirements:

  • 3-5+ years medical‑review experience at a UPIC or MAC (e.g., Safeguard Services, Qlarant, CoventBridge
  • Noridian, CGS, NGS, WPS, Novitas, Palmetto)
  • Hands‑on adjudication of surgical dressings (A6021 collagen
  • A6196–A6199 alginate/fiber‑gelling
  • A6209–A6215 foam
  • A6212–A6214 bordered foam
  • A6216–A6221 gauze
  • A6257–A6259 film)
  • Expert with proof‑of‑delivery standards, SWO requirements, frequency/sizing rules, and common denial rationales (e.g., two‑cover stacking, over‑frequency without rationale, DOS/POD mismatch)
  • Crisp, policy‑anchored writing
  • calm under deadline
  • disciplined with PHI
What we offer:
  • Comprehensive Health & Wellness: We cover 100% of your health insurance premium and provide access to high-quality dental and vision insurance plans for you and your dependents
  • Plan for the Future: We offer a 401(k) plan to help you save for your future
  • Career Growth: You'll have opportunities for rapid career advancement in a company that's at a major inflection point

Additional Information:

Job Posted:
February 18, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Medical Reviewer, Surgical Dressings

Medical Assistant

At CVS Health, we're building a world of health around every consumer and surrou...
Location
Location
United States , Huntsville
Salary
Salary:
18.50 - 35.29 USD / Hour
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
February 23, 2026
Flip Icon
Requirements
Requirements
  • High school diploma or equivalent required
  • 5+ years prior relevant work experience
  • Adept at problem solving and decision making skills
  • Medical Assistant Certification Preferred
  • Phlebotomy Certification Preferred
Job Responsibility
Job Responsibility
  • Performs a variety of patient care duties within the construct of a multidisciplinary patient care team as delegated by the physician
  • Serves as an assistant to physicians and nurses for physical examination and treatments, while performing surgical preps and simple dressing changes
  • Prepares patient for examination by performing and recording preliminary vitals such as blood pressure, temperature, and weight
  • Communicates abnormal symptoms, unusual conditions, or adverse reactions to physicians to proactively address and resolve issues
  • Records patient medical history and specific information related to the reason for visit by interviewing the patient
  • Coordinates with internal stakeholders about clinic scheduling problem solving, patient wait times, and other areas of concern to increase efficiency
  • Administers the supervision of work and performance of clinic staff, medical assistants, and other support staff, as instructed, including input for performance reviews and corrective action plans as needed
  • Provides coaching of non-medical staff to increase medical knowledge to ensure compliance with the company's regulatory, safety, quality, and confidentiality protocols and standards
  • Operates with a sense of urgency and flexibility to meet the needs of a rapidly changing environment, while meeting performance standards set for quality and quantity of work
What we offer
What we offer
  • Affordable medical plan options
  • 401(k) plan with matching company contributions
  • Employee stock purchase plan
  • No-cost wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Fulltime
!
Read More
Arrow Right
New

Clinical Oncology Associate

The Clinical Oncology Associate provides clinical office support to physicians a...
Location
Location
United States , New York
Salary
Salary:
28.13 - 30.17 USD / Hour
mountsinai.org Logo
Mount Sinai Health System
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School Diploma/GED
  • Associates degree in Medical Assisting preferred
  • 0-2 yrs. experience as medical assistant or related experience
  • Completion of an accredited certificate course of study as Medical Assistant required
  • Certified Medical Assistant preferred
Job Responsibility
Job Responsibility
  • Fulfills patient care responsibilities as assigned which may include: performing venipuncture and/or EKGs, checking schedules and organizing patient flow
  • accompanying patients to exam/procedure room, assisting patients as needed with walking, transferring and dressing, as well as collecting and processing specimens and point of care testing, preparing for exam, etc. Assists physicians with various procedures, takes vital signs, relays instructions to patients and or families
  • answers calls and provides pertinent information
  • Fulfills clerical responsibilities as assigned which may include: sending and receiving patient medical records
  • obtaining lab/x-ray reports, hospital notes, referral information, etc. Completing forms and requisitions as needed, managing charts to ensure information is completed and filed appropriately. These responsibilities may be carried out using the electronic medical record (EMR) system or manually as necessary
  • Enters orders into the electronic medical record (EMR) system or prepares prescription refill requests on behalf of the physician for the review and approval by the ordering physician
  • Inventories, orders or re-stocks medical supplies as applicable
  • Provides set-up of examination room and instruments in accordance with proper sterilization techniques established by hospital and infection control policies
  • Maintains logging system as required for refrigeration of medications, point of care testing, sterilization process, crash cart, point of care testing or others as needed
  • Checks expiration dates on all medications and medical supplies disposing appropriately as per institution policy
  • Fulltime
Read More
Arrow Right

ORC Supervisor, Sterile Processing

At STERIS, we help our Customers create a healthier and safer world by providing...
Location
Location
United States , Concord
Salary
Salary:
63400.00 - 87175.00 USD / Year
steris.com Logo
STERIS
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School Diploma or GED
  • Minimum 4 years of hands-on sterile processing experience with one year of leadership (supervisor level or above) experience with direct reports, or 2 years of lead experience required
  • Strong computer skills required including a working knowledge of MS Word and MS Excel
  • Active certification in sterile processing/central sterile via CBSPD or IAHCSMM required. If not certified at point of hire, it must be obtained within 12 months of hire
  • If assigned to travel, must maintain valid driver’s license, vehicle insurance and be available to operate a vehicle as needed to meet travel requirements
  • Must have a good working knowledge of Instruments, the operation/workings of the OR and be able to readily understand their issues and requests
  • Ability to act as a resource for staff in both SPD and OR regarding identification and assembly of specialty instrument trays
  • Ability to train in all procedures regarding SPD responsibilities
  • Ability to schedule and maintain department productivity
  • Excellent written and verbal communication skills
Job Responsibility
Job Responsibility
  • Provides on-site support, training, and communication regarding the reprocessing of surgical instruments and trays to contracted facilities in compliance with the Department of Health, TJC, OSHA, CDC, AAMI and AORN standards and facilities goals and policies
  • Coordinates and manages day-to-day operations of SPD employees
  • Oversees and supports daily operations of all activities that relate to the reprocessing of reusable medical supplies and instrumentation including decontamination, cleaning, assembly, wrapping, sterilization, and storage processes within all set professional standards and regulations
  • Ensures proper operational procedures are followed by all members of the IMS team
  • Assumes responsibility, in collaboration with IMS SPD manager, for scheduling new IMS employee orientation, on-the-job training, in-service education and IMS or facility quality assurance programs when needed
  • Understands and promotes concepts of the Lean work environment
  • Communicates in a professional manner both verbally and in writing to all hospital staff and company employees
  • Exhibits professional behavior in all telephone and electronic communications
  • Represents IMS, self and profession positively in all public arenas
  • Practices within the scope of certification and job description
What we offer
What we offer
  • bonus participation
  • comprehensive and competitive benefits portfolio
  • Fulltime
Read More
Arrow Right

ORC Supervisor, Sterile Processing

At STERIS, we help our Customers create a healthier and safer world by providing...
Location
Location
United States , Concord
Salary
Salary:
63400.00 - 87175.00 USD / Year
steris.com Logo
STERIS
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum 4 years of hands-on sterile processing experience with one year of leadership (supervisor level or above) experience with direct reports, or 2 years of lead experience required
  • High School Diploma or GED
  • Active certification in sterile processing/central sterile via CBSPD or IAHCSMM required. If not certified at point of hire, it must be obtained within 12 months of hire
  • Strong computer skills required including a working knowledge of MS Word and MS Excel
  • Must have a good working knowledge of Instruments, the operation/workings of the OR and be able to readily understand their issues and requests
  • Ability to act as a resource for staff in both SPD and OR regarding identification and assembly of specialty instrument trays
  • Ability to train in all procedures regarding SPD responsibilities
  • Ability to schedule and maintain department productivity
  • Excellent written and verbal communication skills
  • Ability to work daily in a fast-paced, high-pressure Healthcare Services environment
Job Responsibility
Job Responsibility
  • Provides on-site support, training, and communication regarding the reprocessing of surgical instruments and trays to contracted facilities
  • Coordinates and manages day-to-day operations of SPD employees
  • Oversees and supports daily operations of all activities that relate to the reprocessing of reusable medical supplies and instrumentation including decontamination, cleaning, assembly, wrapping, sterilization, and storage processes
  • Ensures proper operational procedures are followed by all members of the IMS team
  • Assumes responsibility, in collaboration with IMS SPD manager, for scheduling new IMS employee orientation, on-the-job training, in-service education and IMS or facility quality assurance programs when needed
  • Understands and promotes concepts of the Lean work environment
  • Communicates in a professional manner both verbally and in writing to all hospital staff and company employees
  • Exhibits professional behavior in all telephone and electronic communications
  • Represents IMS, self and profession positively in all public arenas
  • Practices within the scope of certification and job description
What we offer
What we offer
  • Bonus participation
  • Comprehensive and competitive benefits portfolio
  • Fulltime
Read More
Arrow Right
New

Lead Samsung Experience Consultant

Become a Full-Time, Bi-Lingual Retail Sales Associate for Samsung Electronics Am...
Location
Location
United States , Miami Beach
Salary
Salary:
22.00 USD / Hour
2020companies.com Logo
2020 Companies, Inc
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High school diploma or equivalent required
  • Six (6) months prior sales, retail, telecom or marketing experience preferred
  • Demonstrated knowledge of products and services
  • Excellent communications, presentation, interpersonal and problem-solving skills
  • Impeccable integrity and commitment to customer satisfaction
  • Ability to work independently and manage multiple priorities in a fast-paced environment
  • Availability to work weekend evening and high demand retail holidays
  • Ability to maintain customer confidentiality
Job Responsibility
Job Responsibility
  • Drive sellout of Samsung mobile products and services within a Best Buy retail store utilizing conversational consulting sales techniques
  • Uncover and understand the needs of the customer and recommend a Samsung product to fit and fill those needs
  • Build confidence in Samsung products and services for both Best Buy employees, new and repeat customers as a brand evangelist
  • Build strong partnerships with Best Buy staff with the purpose of driving the key initiatives and goals of all teams
  • Meet or exceed personal and store sales goals on a monthly basis
  • Provide excellent customer and client service through interaction with both customers and Best Buy employees
  • Ensure retail brand standards are met through merchandising, security, installation, and cleanliness
  • Complete display resets upon request and during new product launches
  • Complete daily reporting on sales performance and retail insights
What we offer
What we offer
  • Competitive, weekly pay
  • Earn a bonus, paid quarterly
  • Next day pay on-demand with DailyPay
  • Paid training completed online, at home via computer or mobile device
  • Apparel Provided
  • Company provided Tablet or Phone
  • Samsung/Otterbox Employee Discounts
  • Exciting work environment to showcase your customer service skills
  • Share and learn with ongoing training and development
  • Work an average of 32+ hours per week
  • Fulltime
Read More
Arrow Right
New

Senior Software Engineer, Backend

Credit Genie is a mobile-first financial wellness platform designed to help indi...
Location
Location
United States; Canada , New York, NY; Plymouth Meeting, PA; Philadelphia, PA; San Francisco, CA; Pittsburgh, PA; Toronto, ON
Salary
Salary:
150000.00 - 250000.00 USD; CAD / Year
creditgenie.com Logo
Credit Genie
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 5+ years of experience designing, building, and scaling high-performance backend systems in a fast-paced, high-growth environment
  • Expertise in architecting and productionizing large-scale distributed systems
  • Comfortable working across multiple technical areas and collaborating with frontend/mobile teams
  • Passion for tackling complex challenges with structured thinking and analytical rigor
  • Ability to break down intricate systems, identify flaws, and implement scalable, secure, and maintainable solutions
  • Thrives in a fast-moving, iterative environment with a bias for action
  • Excited to take full ownership of projects, drive impact, and work cross-functionally with product, design, and engineering teams
  • Strong understanding of data privacy, compliance, and secure coding practices
  • Experience with designing resilient and reliable systems that meet high security and regulatory standards
Job Responsibility
Job Responsibility
  • Design, Build, and Scale – Own backend systems end-to-end, from architecture to deployment, ensuring high performance, security, and scalability for next-generation financial products
  • Greenfield Development – Work on new projects from scratch, making foundational technical decisions that will shape our platform for years to come
  • Cross-Functional Collaboration – Partner with product, design, data science, and adjacent engineering teams to build impactful features and solve complex business challenges
  • Technical Leadership – Lead critical technical, design, and product discussions, driving best practices in system design, coding, testing, and DevOps
  • Customer-Focused Innovation – Scope, build, and optimize products and services that deliver immediate and meaningful value to users
What we offer
What we offer
  • Offers Equity
  • Offers Bonus
  • 100% company-paid medical, dental, and vision coverage for you and your dependents on your first day of employment
  • Receive up to $100 per month in fitness reimbursement or enjoy a complimentary full membership to LifeTime Fitness or Equinox
  • 401(k) with a 3.5% match and immediate vesting
  • Meal program available for both lunch and dinner
  • Pre-tax benefits, including a $1,000 HSA match
  • Life and accidental insurance
  • Flexible PTO
  • Fulltime
Read More
Arrow Right
New

Physical Therapist

Facility Name and location: Advantage Clinic - Spokane, WA. Type of therapist: G...
Location
Location
United States , Spokane
Salary
Salary:
Not provided
inabia.com Logo
Inabia Solutions & Consulting
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 3+ years post graduation experience (would consider 2 for a really strong candidate)
  • must have recent ortho experience
  • Fulltime
Read More
Arrow Right
New

Benefits Consultant

At Angle Health, we believe the healthcare system should be accessible, transpar...
Location
Location
United States
Salary
Salary:
150000.00 - 300000.00 USD / Year
anglehealth.com Logo
Angle Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Licensed Accident/Health Producer in good standing with home state within 90 days of hire
  • Highly organized, motivated, outcome-oriented, and target-driven
  • Strong interpersonal and communication skills
  • Ability to clearly and concisely articulate key value propositions and quickly build trust
  • Entrepreneurial, self-directed, and excited to build something from scratch
  • Ability to work autonomously
  • Driven to exceed expectations
  • A passion for bringing best-in-class products to solve problems for and satisfy customers
Job Responsibility
Job Responsibility
  • Proactively engage with potential customers within your market to increase top-of-funnel candidates
  • Develop and maintain deep knowledge about Angle Health's products and platform, those of our competitors, and the healthcare and health insurance industry
  • Communicate Angle’s offerings clearly and compelling through language and live demos, and identify how our solutions meet prospective customers’ needs
  • Maintain positive and constant communication with clients to ensure client satisfaction
  • Must be willing to travel to meet with clients, however, some office time is required to meet successful goals
  • Coordinate and actively shepherd groups through the sales cycle, including proposals, underwriting, contract negotiations, and finalized policies
  • Work with your manager for ongoing training opportunities
  • Assist in coordinating events or attending events within the insurance space to broaden top-of-funnel opportunities and Angle Health’s market exposure
  • Engage with the insurance community to increase customer referrals and testimonials, and decrease customer churn rates
  • Collaborate with our internal teams to successfully drive sales and close new business
What we offer
What we offer
  • Competitive compensation
  • 100% company-paid comprehensive health, vision & dental insurance for you and your dependents
  • Supplemental Life, AD&D and Short-Term Disability coverage options
  • Discretionary time off
  • Opportunity for rapid career progression
  • 3 months of paid parental leave and flexible return to work policy (after 12 months of employment)
  • Work-from-home stipend for remote employees
  • 401(k) account
  • Other benefits are coming soon
  • Fulltime
Read More
Arrow Right