TMF Health Quality Institute
TMF Health Quality Institute Jobs
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Job Description:
Are you looking for a full-time job that you can do from home? TMF Health Quality Institute is looking for a DRR I (Non-Healthcare Professional) to join their team. This job will let you help improve healthcare services and make decisions that affect people’s healthcare.
As a DRR I, your main job will be to review healthcare cases, especially related to Medicare. You will help decide if an enrollment denial, revocation, or suspension should be allowed based on the information in the case. Your job is to make fair and clear decisions that follow the rules, policies, and guidelines.
You will be working on important tasks that affect people’s health. This is a great opportunity if you like working on your own but also following rules and guidelines. You will work with a team of people who care about improving healthcare. If this sounds like a job you would like, keep reading!
Job Details
Position Title:
DRR I (Non-Healthcare Professional)
Company:
TMF Health Quality Institute
Location:
Remote, Anywhere in the USA
Job Type:
Full-time
Posted On:
January 6, 2025
Category:
Program Management
Requisition Number:
DRRI0001161
Job Responsibilities:
As a DRR I, you will have several important tasks to do. These include:
1. Case Review:
You will need to look at medical records and other important documents to understand the case. Then, you will write clear and fair decisions based on what you find.
2. Independent Decision-Making:
You will make decisions on your own. Your decisions will be based on the medical information, rules, laws, and guidelines that apply to the case.
3. Responding to Questions:
You will talk to people who have questions about their cases. This could be beneficiaries, their representatives, suppliers, or providers. You will make sure to address their concerns fairly and quickly.
4. Fair and Impartial Decisions:
Your job is to make fair decisions. This means you will base your decisions on the evidence and information you have, following the rules and guidelines. Your decisions should be clear and just.
Minimum Qualifications
To apply for this job, you need to meet the following requirements:
Education:
- You need an Associate’s degree or 60+ credit hours towards a Bachelor’s degree in healthcare or a related field from a recognized school.
- If you do not have a degree, you can still apply if you have experience working in Medicare appeals, medical review, or a similar healthcare job. For each year of experience, it can count as one year of education.
Experience:
- You need at least one year of experience working in Medicare appeals, medical reviews, or healthcare compliance.
- If you have experience in appeals and billing, that would be helpful.
- If you have a coding certificate, that is also a plus.
Benefits
When you work at TMF Health Quality Institute, you will get many benefits to help take care of you and your family. These benefits include:
- Medical, dental, vision, and life insurance
- Short and long-term disability insurance
- 401(k)
- Accidental Death & Dismemberment (AD&D) insurance
- Section 125 plan
- Tuition reimbursement
- License/credentials reimbursement
- Competitive salary
How to Apply
To apply for the DRR I (Non-Healthcare Professional) job, you need to create an account on Indeed. Once you have an account, fill out the application and include all your education and work history.
It’s very important that your application is complete. If any parts of your application are missing, it may not be considered. The first part of the review will look at if you meet the basic requirements, like education and experience.
Why Work at TMF Health Quality Institute?
TMF Health Quality Institute cares about helping both its employees and the people who rely on healthcare services. Working remotely means you can manage your own schedule while still contributing to the healthcare system.
This job is a great way to grow your career in the healthcare field while making a positive impact. If you like making decisions based on rules and evidence, and you meet the requirements listed above, this could be the job for you!
Equal Opportunity Employer Statement
TMF Health Quality Institute is an Equal Opportunity Employer. This means that everyone has the same chance to apply, no matter their race, gender, disability, or veteran status. The company is committed to making sure everyone has equal rights when it comes to applying for and working at the company.
The company also ensures that employees cannot be fired or treated unfairly because they asked about their pay or someone else’s pay, as long as it is done the right way.
Take the Next Step in Your Career Today!
If you meet the qualifications and want to join a company that is making a difference in healthcare, don’t wait! Apply now for the DRR I (Non-Healthcare Professional) position and start your new career with TMF Health Quality Institute!