Medical Reviewer

• Review medical bills and documentation according to guidelines and company policies and procedures
• Determine whether treatment is related and necessary to the covered injury
• Assess appropriate use of medical coding
• Identify over-utilization of treatment and make appropriate reimbursement recommendations for Michigan Workers' Compensation claims
• Provide customer service to adjusters, providers, and claimants regarding bill review
• Assess appropriateness and duration of care for possible utilization review
• Recommend independent medical evaluations (IME) to adjusters when necessary
• Act as a resource to other staff members to facilitate completion of a quality product
• Use appropriate reference material to perform professional review
• Meet company productivity and quality standards
• Maintain quality, timeliness, and customer service for assigned accounts

Explore Medical Review Specialist at Medlogix. Review requirements and application details.