Michigan Licensed Medical Review Specialist

Job Summary

Reviewing medical bills for Michigan Workers' Compensation claims, the full-time remote Michigan Licensed Medical Review Specialist will utilize clinical expertise to assess treatment necessity, apply review guidelines, and provide reimbursement recommendations while ensuring quality customer service.

Key responsibilities

• Review medical bills and documentation according to established guidelines and policies
• Determine the relationship and necessity of treatment related to covered injuries
• Advise on appropriate reimbursement recommendations and assist adjusters with independent medical evaluations when necessary

Required qualifications

• Certified Professional Coder certification is required
• 1+ years of medical coding experience (CPT, ICD-10) is preferred
• 1+ years of experience in Medical Bill Repricing is preferred
• Experience with Michigan Workers' Compensation is preferred
• Proficiency in Microsoft Office products is required