Medical Review Specialist- REMOTE - Southfield
1 month ago

The incumbent reviews medical bills utilizing professional knowledge and clinical experience to determine relationship of services billed to the covered injury; applies appropriate review guidelines, assesses appropriate use of medical coding; identifies over-utilization of treatment and makes appropriate reimbursement recommendations.
+Responsibilities
- 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.
Qualifications
Job description
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