Medical Review Specialist
Medlogix
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $48,000 - $55,000 per year
Job Level
About the role
- Reviews medical bills and documentation according to guidelines and RW policies and procedures.
- Determines if treatment is related and necessary to the covered injury.
- Advises reimbursement recommendations are appropriate.
- Provides customer service to adjusters, providers, and claimants regarding bill review.
- Assesses appropriateness and duration of care provided, for possible utilization review.
- Recommends independent medical evaluations (IME) to adjusters when necessary.
- Act as a resource to other staff members to facilitate completion of a quality product.
- Use appropriate reference material as necessary to perform professional review.
- Meets company productivity standards.
- Meets company quality standards.
Requirements
- 1+ years medical coding experience – CPT, ICD-10 - preferred
- 1+ years’ experience in Medical Bill Repricing – preferred
- Certified Professional Coder – a plus but not required
- StrataWare software- a plus, but not required
- Ability to apply clinical knowledge and/or coding expertise in bill review
- Ability to read, write, speak, and understand English well
- Ability to understand and follow written and oral instructions
- Possess strong verbal and interpersonal skills
- Ability to multi-task
- Possess problems solving skills
- Ability to sit for long periods at a computer terminal keyboarding
- PC skills – required
- Knowledge of Microsoft Office Products – required
- Ability to operate standard office equipment including telephone
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical codingCPTICD-10medical bill repricingclinical knowledgecoding expertisebill reviewproblem solvingkeyboard skillsPC skills
Soft Skills
customer serviceverbal skillsinterpersonal skillsmulti-taskingfollowing instructions
Certifications
Certified Professional Coder