Medical Review Specialist

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

Medical Review Specialist

Location: Atlanta, GA

Pay Rate: $25.00 per hour

Schedule: 8:30 AM - 5 PM

Looking for Medical Review Specialist jobs in Atlanta where your skills can make a real impact? This opportunity offers the chance to contribute to a growing team, develop your experience, and build a rewarding career in a professional work environment.

Job Duties

• Review medical records, billing documents, and claims to prepare accurate reports using industry guidelines and client requirements.
• Process medical claims by identifying billing types and entering data into review systems for adjudication and analysis.
• Apply CPT, ICD-10, CMS, fee schedule, and coding guidelines to ensure accurate claim reviews and billing compliance.
• Perform quality assurance reviews to verify accuracy, completeness, and regulatory compliance before finalizing reports.
• Communicate with clients to resolve missing information, billing discrepancies, report status requests, and claim-related questions.
• Maintain organized documentation and ensure all records are audit-ready while adhering to HIPAA, state, and federal regulations.

Requirements

• Current certification in OASIS, RAC-CT, or CCS required.
• Strong knowledge of medical billing, coding, fee schedules, CPT, ICD-10, CMS guidelines, utilization review, and billing compliance standards.
• Experience reviewing various claim types, including physician, hospital, surgical center, drug, and supply charges.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook), internet applications, and general office equipment.
• Ability to type a minimum of 35 WPM and accurately manage detailed data entry tasks.
• Excellent communication, organization, time management, problem-solving, and confidentiality skills with the ability to work independently in a fast-paced environment.

Preferred Skills

• Strong attention to detail and commitment to quality assurance.
• Ability to prioritize multiple assignments and meet deadlines.
• Experience handling provider appeals and claim resolution processes.
• Knowledge of HIPAA compliance and healthcare industry regulations.
• Team-oriented mindset with the ability to adapt to changing workloads and business needs.

Benefits

• Competitive Weekly Pay
• Comprehensive Benefits including medical, dental, and vision coverage.
• Life Insurance and Disability Insurance for added peace of mind.
• Optional 401(k) Plan to help you prepare for the future.
• Opportunities for Growth through a variety of assignments with leading employers.

Marvin's Take? Fast and Straightforward

"They get you on the job fast." - Marvin, Staffmark Associate

About Us

At Staffmark, we connect hardworking people with great companies, creating opportunities that make a lasting impact.

Staffmark is an equal opportunity employer. Allapplicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other legally protected status. Staffmark offers reasonable accommodations for qualified individuals with disabilities; contact your local branch for inquiries. Staffmark is an E-Verify employer. See our Privacy Notice for Candidates and Employees/Contractors at https://smgroupna.com/privacy-notice-for-candidates-and-employees-contractors. By applying, you consent to receive AI-generated and non-AI-generated calls, texts, or emails from Staffmark Group, its affiliates, and partners. Frequency varies and message/data rates may apply. Reply STOP to cancel or HELP for help.