Medical Review Specialist

🕒 July 28

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Logo of Medlogix

Medlogix

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

• 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

• 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

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