Adecco Medical & Science is currently recruiting for a temporary Medical Record Reviewer job this position is remote; however, you must be available to work Monday through Friday 6AM-6PM CST; 8 hours a day. As a Medical Record Reviewer you would be evaluating and prioritizing of allegations/tips and referral to the appropriate internal team; reviewing member claim history, and review medical documentation; investigating, recovering and resolving all types of claims as well as recovery and resolution for various entities.
Medical Record Reviewer job responsibilities include:
• Review medical records to determine if records support billed claim
• Document in a professional manner the investigation activities that were performed during review
• Adjust claims as needed based on investigation performed
• Refer tip / allegation to the appropriate internal team (Fraud & Abuse / Waste & Error)
• Submit CMS reporting as required
• Ensure adherence to state and federal compliance policies and reimbursement policies.
• Undergraduate degree or, Associates Degree with 4+ years of insurance or fraud investigation experience or, High School diploma / GED with 5+ years of insurance or fraud investigation experience
• 2+ years of insurance or healthcare experience with one or more of the following: claim processing, provider demographic information or insurance billing practices
• 2+ years of experience with CPT coding, nursing, or medical record review
If you are interested in this remote Medical Record Reviewer job opportunity then please click APPLY NOW. For other opportunities available at Adecco Engineering and Technical go to www.adeccousa.com. If you have questions about the position please contact Ashley Gruver at 315-385-4172 or firstname.lastname@example.org
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
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