Medical Review Specialist – Remote, Eastern Time Zone

Job overview

The Medical Review Specialist role is fully remote for the Eastern Time zone; compensation is $24–$27 per hour. The role supports ReviewWorks, a Medlogix company providing medical review and related services to insurers, third-party administrators, and other clients. The specialist reviews medical bills and records to assess whether services relate to and are necessary for covered injuries, applying review guidelines and coding knowledge. The work supports accurate reimbursement recommendations, quality and timely account service, and the medical claims review process.

What you'll do

• Review medical bills and documentation under company guidelines
• determine whether treatment relates to and is necessary for covered injuries
• recommend appropriate reimbursement
• respond to adjusters, providers, and claimants
• assess care appropriateness and duration for possible utilization review
• recommend independent medical evaluations when necessary
• support staff
• use reference materials
• and meet productivity and quality standards.

What we're looking for

Skills & competencies

medical review specialist

fully remote

eastern time zone

medical bill review

workers' compensation

medical coding

certified professional coder

cpt

icd-10

$24–$27 per hour

medlogix

Work arrangement

• Weekend coverage required

Why this role

Certified Professional Coder is required; CPT and ICD-10 coding, medical bill repricing, and Michigan workers’ compensation experience are preferred.

About the employer

MEDLOGIX, LLC is hiring for this role. Industry: All Other Insurance Related Activities. Sector: 52.