Montana Licensed Medical Review Technician

Job Summary

Coordinating and collaborating in the medical review process, the full-time Montana Licensed Medical Review Technician will manage daily work assignments, assist with incoming faxes, and ensure accurate coding using CPT and ICD codes while working remotely.

Key responsibilities

• Manages daily work assignments and coordinates the receipt and entry of pretreatments and pre-certification requests
• Communicates with providers to obtain complete and accurate information and performs quality controls on review responses
• Documents in the Care Management Platform with accuracy and timeliness, facilitating peer-to-peer requests as necessary

Required qualifications

• High school graduation or GED required
• Preferred experience in medical terminology and medical coding
• Knowledge of basic health insurance concepts
• Ability to analyze and interpret insurance documents and regulations
• Proficient in PC skills, including Windows and Word