Medical Review Specialist III (All Medicare claim types)

As a casual Medical Review Specialist III (Medical Reviewer III) you will primarily perform Medicare comprehensive medical record and claims review to make payment determinations for Medicare claims (all claim types). Perform projects or duties as assigned as a Medical Review Specialist. You will serve as a critical component in meeting our mission of providing excellent services to our clients. Your experience ensures an exciting and rewarding opportunity to be at the forefront of activities related to implementing healthcare reform on a national level. This is a casual position. Responsibilities include performing comprehensive medical record and claims review to make payment determinations based on insurance coverage, coding, and utilization of services and practice guidelines for Medicare claims. You will also conduct in-depth claims analysis utilizing ICD-10-CM, CPT-4, and HCPCS Level II coding principles, utilizing electronic health information imaging and input medical review decisions by electronic database module.