Medical Bill Review & Coding Specialist

MEDLOGIX, LLC; Southfield (MI); Remote; USD 48,000 - 70,000; Full time

Job summary

Medlogix, LLC in Southfield, MI is seeking a Medical Review Specialist to evaluate medical bills for Michigan Workers' Compensation claims. You will apply clinical knowledge and coding expertise to determine the relation of services to injuries and provide reimbursement recommendations with RW guidelines.

Strong English, organization, and independent work are essential. The role is full-time, non-exempt, requiring 40 hours weekly and a focus on quality and customer service for adjusters and

Qualifications

• Certified Professional Coder required.
• 1+ years medical coding experience – CPT, ICD-10 - preferred.
• 1+ years’ experience in Medical Bill Repricing – preferred.
• Michigan Workers' Compensation experience- preferred.

Responsibilities

• Reviews medical bills and documentation according to RW guidelines and policies.
• Determines if treatment is related and necessary to the covered injury.
• Advises reimbursement recommendations are appropriate and provides customer service to adjusters, providers and claimants.
• Assesses appropriateness and duration of care for possible utilization review.
• Recommends independent medical evaluations (IME) to adjusters when necessary.
• Acts as a resource to other staff to facilitate a quality product.
• Uses reference material as necessary to perform professional review.
• Meets company productivity and quality standards.

Skills

Clinical knowledge

Medical coding

English proficiency

Multitasking

Problem solving

MS Office

Office equipment

Education

Certified Professional Coder

Tools

Microsoft Office

Job description

Medlogix, LLC in Southfield, MI is seeking a Medical Review Specialist to evaluate medical bills for Michigan Workers' Compensation claims. You will apply clinical knowledge and coding expertise to determine the relation of services to injuries and provide reimbursement recommendations with RW guidelines.

Strong English, organization, and independent work are essential. The role is full-time, non-exempt, requiring 40 hours weekly and a focus on quality and customer service for adjusters and