Medical Review Specialist

Job not on LinkedIn

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $24 - $27 / hour

⏰ Full Time

🟠 Senior

🔴 Lead

🔍🏥 Medical Reviewer

👻 Ghost score 0%

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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 • Assess appropriate use of medical coding • Identify over-utilization of treatment and make appropriate reimbursement recommendations for Michigan Workers' Compensation claims • 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 and quality standards • Maintain quality, timeliness, and customer service for assigned accounts

🎯 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