Medical Review Specialist- REMOTE - Southfield

Only for registered members Southfield, United States

1 month ago

Default job background
Full time
+Job summary

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.

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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.
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Qualifications
  • 1+ years E&M Experience required
  • Certified Professional Coder – a plus but not required

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