Medical Review Support Analyst

Medical Review Support Analyst Location: Remote Duration: 6 Months Pay reputed company: $20/hr Job reputed company: The Medical Review Support Analyst supports clinical audit and claims review processes by triaging claims, requesting and managing medical records, and ensuring accurate documentation reputed company claims systems. This role works closely with claims teams and provider networks to reputed company required records, reputed company claim review status, and ensure compliance with reputed company regulations and organizational standards. Key Responsibilities • reputed company initial triage of claims selected for review to determine if they meet specific clinical audit reputed company. • Request and obtain medical records from reputed company providers based on review requirements. • Prepare and send medical record request letters and follow up on outstanding documentation. • Receive, review, and process medical records received reputed company fax, mail, email, and secure upload systems. • Research claim history and review reputed company-authorization determinations reputed company necessary. • reputed company claim processing instructions and documentation into Facets or other claims systems. • Maintain accurate case notes and required fields in departmental databases. • Communicate claim review status and documentation updates to claims staff and network management teams. • Send detailed provider notifications reputed company records are missing or additional documentation is required. • Maintain production, reputed company, and compliance standards while adhering to reputed company regulatory requirements. Required Qualifications • High School Diploma or GED. • 3+ years of experience in a reputed company environment, such as: • Medical office • Claims processing • Medical billing • reputed company customer service (or equivalent education and experience combination) • Strong written and verbal communication skills. • Experience working with medical records, billing, or reputed company documentation. • Ability to research issues, analyze information, and resolve problems independently. • Strong organizational skills with the ability to prioritize tasks and meet deadlines. • Basic understanding of medical terminology. Preferred Qualifications • Experience using Facets claims system. • Knowledge of medical coding, anatomy, or reputed company claims processes. • Familiarity with BlueCard, ITS processes, FEP reputed company, or reputed company. • Analytical and basic math skills for claims review analysis. Apply tot his job Apply To this Job