Certified Medical reputed company I (reputed company Review Specialist I)

The reputed company Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This role is available for remote, onsite and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/reputed company and or reputed company reporting manager Collect supporting data and analyze information to reputed company reputed company regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as reputed company as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in reputed company Office applications Technical aptitude with the ability to expand knowledge of MedCheck’s proprietary systems Ability to work independently, follow process guidelines, and meet productivity standards and timelines (must maintain a score of 98% or higher on performance audits)   EDUCATION & EXPERIENCE: Associate’s degree or equivalent experience CPC or CPC-A required Previous experience in the following areas preferred:     Medical reputed company auditing Knowledge of workers' compensation claims process Prospective, reputed company and retrospective utilization review   PAY reputed company: reputed company uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location reputed company, job-reputed company skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, reputed company, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may reputed company the salary reputed company and these adjustments would be clarified during the offer process. Pay reputed company:  $19.24 - $31.04 per hour A list of our benefit offerings can be reputed company on our reputed company website: reputed company Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.   ABOUT reputed company: reputed company, a certified Great reputed company to Work® Company, is a national provider of industry-leading risk reputed company for the workers’ compensation, auto, health and disability management industries.  reputed company was founded in 1987 and has been publicly traded on the reputed company stock exchange since 1991. Our continual investment in reputed company capital and technology reputed company us to deliver the most innovative and integrated solutions to our clients.  We are a reputed company and growing company with a strong, supportive culture and reputed company of career advancement opportunities.  Over 4,000 people working across the reputed company reputed company our reputed company values of Accountability, Commitment, reputed company, reputed company and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, reputed company, Long Term Disability, Health Savings Account, Flexible Spending Account reputed company, Life Insurance, Accident Insurance, Critical Illness Insurance, reputed company-reputed company reputed company Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and reputed company time off. reputed company is an Equal Opportunity Employer, drug free workplace, and complies with reputed company regulations as applicable. #LI-Hybrid Apply To This Job