Medicare DMEPOS Medical Reviewer, Surgical Dressings (Contract) - Remote

Overview

Verse Medical is building the software infrastructure to enable hospital-quality care at home, addressing the underserved needs of patients recovering at home.

In Short

• Role involves ensuring compliance with CMS regulations for surgical dressings.
• Requires interpretation of LCDs and MAC policies into actionable checklists.
• Engagement is part-time, approximately 10 hours per week.
• Remote work is available but requires adherence to East Coast time.
• Involves pre-bill controls and quality assurance processes.
• Leads audit and appeals processes related to surgical dressing claims.
• Requires medical review experience with UPIC or MAC.
• Strong writing skills and ability to handle deadlines are essential.
• Nice-to-haves include RN/WOCN background and experience with denial analysis.
• Part of a rapidly expanding Series C company in healthcare technology.

Requirements

• 3–5+ years medical review experience at a UPIC or MAC.
• Hands-on adjudication experience with surgical dressings.
• Expertise in proof-of-delivery standards and denial rationales.
• Strong policy-anchored writing skills.
• Ability to remain calm under deadlines and handle PHI with discipline.
• Nice-to-haves: RN/WOCN or wound-care background.
• Experience with Excel/BI/SQL for denial analysis is a plus.

Benefits

• Opportunity to work with a leading healthcare technology company.
• Flexible remote work environment.
• Engagement in a growing field with significant impact on patient care.
• Collaborate with a dedicated team of professionals.
• Potential for professional growth within a Series C company.