Job description
Avid Systems is seeking a qualified Medical Examiner (Registered Nurse) to support evaluations of medical claim information, including illnesses, treatment recommendations, hospitalization factors, and appropriate leave periods.
Key Responsibilities:
- Reviewand evaluate medical claims and documentation submitted for Paid Family Leave purposes.
- Assess the appropriateness of illness diagnoses, treatment plans, hospitalization details, and recommended leave periods.
- Apply expert knowledge of ICD-10 codes and current clinical guidance.
- Collaborate with PFL staff through daily interactions onsite or virtually.
- Maintain accurate records and ensure compliance with all medical review standards.
Qualifications
- Active Registered Nurse (RN) license.
- Minimum of 5 years of hands-on clinical and/or general practice nursing and medical certification review experience.
- Prior work experience in the medical field within the past 12 months.
- Demonstrated expertise in ICD-10 coding and familiarity with relevant treatment plans.
- Up-to-date knowledge of COVID-19 symptoms and current treatment protocols.
- Resume must include active certifications, education background, and valid licensure.
- Three professional references required, including the quality of the personnel’s past performance, their previous titles, number of years of experience, and organization of employment. All references shall include contact information including the names, telephone number and email addresses of the referenced sources.
- Availability for 15–20 hours per week during business hours (Monday - Friday, 8:30 AM–5:00 PM, excluding federal and district holidays).
- Ability to work onsite at DOES Headquarters in northeast Washington, DC, or have virtual access to work remotely.
