Medical Review Analyst

Job Summary

A company is looking for a Medical Review Support Analyst to support clinical audit and claims review processes.

Key Responsibilities

• Perform initial triage of claims selected for review to determine if they meet specific clinical audit criteria
• Request and obtain medical records from healthcare providers based on review requirements
• Maintain accurate case notes and required fields in departmental databases

Required Qualifications

• High School Diploma or GED
• 3+ years of experience in a healthcare environment, such as medical office, claims processing, or healthcare customer service
• Experience working with medical records, billing, or healthcare documentation
• Basic understanding of medical terminology
• Ability to research issues, analyze information, and resolve problems independently