Certified Medical Claims Reviewer

Staffmark Group; Atlanta (GA); On-site; USD 28,000 - 40,000; Full time

Benefits offered by this job

Competitive weekly pay

Comprehensive benefits

Life Insurance and Disability

401(k) plan

Growth opportunities

Job summary

Staffmark Group in Atlanta, GA seeks a Medical Review Specialist to review medical records, billing documents, and claims for accurate reports and adjudication in line with industry guidelines.

The role offers $25.00 per hour, a 8:30 AM to 5 PM schedule, and a professional work environment. You will apply CPT, ICD-10, CMS guidelines, ensure HIPAA compliance, and maintain audit-ready documentation while communicating with clients to resolve discrepancies.

Qualifications

• Current certification in OASIS, RAC-CT, or CCS required.
• Strong knowledge of medical billing, CPT, ICD-10, CMS guidelines.
• Experience reviewing multiple claim types (physician, hospital, surgical center, drug, supplies).
• Proficient with Word, Excel, Outlook and data entry tasks.
• Ability to type a minimum of 35 WPM and manage detailed data entry.
• Excellent communication, organization, time management and confidentiality.

Responsibilities

• Review medical records, billing documents, and claims to prepare accurate reports.
• Process medical claims by identifying billing types and entering data for adjudication.
• Apply CPT, ICD-10, CMS guidelines to ensure accurate reviews and billing compliance.
• Perform QA reviews to verify accuracy, completeness and regulatory compliance.
• Communicate with clients to resolve missing information and billing discrepancies.
• Maintain audit-ready documentation and HIPAA/state/federal compliance.

Skills

Billing & coding

Data entry

Communication skills

HIPAA compliance

Confidentiality

Education

OASIS, RAC-CT, or CCS certification

Tools

Microsoft Office

Job description

Staffmark Group in Atlanta, GA seeks a Medical Review Specialist to review medical records, billing documents, and claims for accurate reports and adjudication in line with industry guidelines.

The role offers $25.00 per hour, a 8:30 AM to 5 PM schedule, and a professional work environment. You will apply CPT, ICD-10, CMS guidelines, ensure HIPAA compliance, and maintain audit-ready documentation while communicating with clients to resolve discrepancies.