Medical Review Specialist

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $48k - $55k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🔍🏥 Medical Reviewer

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Medlogix

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Private Equity Round on 2017-06

Healthcare • Consulting • Logistics

Medlogix is a company that specializes in providing comprehensive medical services, including workers' compensation, auto medical services, and group health services. They offer online referral systems and eBilling solutions to streamline the management of medical claims. With a focus on technology, Medlogix employs innovative platforms like MyMedlogix™ and MedlogixU™ to enhance their services and ensure exceptional client experiences.

📋 Description

• Review medical bills and documentation according to guidelines and company policies and procedures • Determine whether treatment is related and necessary to the covered injury • Provide appropriate reimbursement recommendations • Provide customer service to adjusters, providers, and claimants regarding bill review • Assess appropriateness and duration of care for possible utilization review • Recommend 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 to perform professional review • Meet company productivity standards • Meet company quality standards • Ensure quality, timeliness, and customer service for assigned accounts • Review Michigan Workers' Compensation claims

🎯 Requirements

• Certified Professional Coder — required • 1+ years medical coding experience — CPT, ICD-10 — preferred • 1+ years’ experience in Medical Bill Repricing — preferred • Michigan Workers' Compensation experience — preferred • 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 • Strong verbal and interpersonal skills • Ability to multi-task • Problem-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 • Initiative, drive, creativity and persistence • Good organizational skills • Highest professional ethics • Ability to work independently