Medical Review Technician

Job Summary

A company is looking for a Medical Review Technician.

Key Responsibilities

• Coordinate and manage the medical review process including incoming faxes and pre-certification requests
• Ensure accurate coding using CPT and ICD codes and perform quality controls on review responses
• Document in the Care Management Platform and facilitate communication with external review companies and clinical teams

Required Qualifications

• High school graduation or GED required
• Preferred experience in medical terminology and medical coding
• Ability to learn claims processing software and adapt to changes
• Knowledge of basic health insurance concepts
• Ability to organize and recall detailed information