Certified Medical Review Specialist

Job Summary

To support a temporary project, the part-time Certified Medical Review Specialist will review medical bills and records, apply coding and billing guidelines, and produce accurate reports while working remotely from Atlanta, GA.

Key Responsibilities

• Enter and review medical bills/claims for automated adjudication and manual adjustments
• Apply coding and billing guidelines, including CPT, ICD-10, and CMS standards
• Perform quality assurance on cases and maintain accurate documentation for audit readiness

Required Qualifications

• Current certification required (OASIS, RAC-CT, or CCS)
• Strong understanding of medical billing and fee schedule concepts
• Knowledge of CPT/ICD-10 guidelines and CMS reimbursement
• Proficiency with Microsoft Office and general computer systems
• Typing speed of at least 35 WPM