Medical Review Specialist

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $48k - $55k / year

⏰ Full Time

🟢 Junior

🔍🏥 Medical Reviewer

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Medlogix

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

🤝 B2B

💰 Private Equity Round on 2017-06

Healthcare Insurance • B2B • Workers Compensation

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

• 1+ years medical coding experience – CPT, ICD-10 - preferred • 1+ years’ experience in Medical Bill Repricing – preferred • Michigan Workers' Compensation experience- preferred • Certified Professional Coder – 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 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