Medical Records Content Reviewer
Job Description
A-Line Staffing is now hiring a Medical Records Content Reviewer – Advanced in Harrisburg, PA, please contact Staffing Manager, Tiona Scroggins @ tscroggins@alinestaffing.com.
Job Code: 811726
Pay Rate: $21.00/hour
Schedule: Monday–Friday, 8:00 AM–4:00 PM
Start Date: 2 weeks from offer
Job Summary:
The Medical Records Content Reviewer will review outpatient medical records and Medicaid claims to ensure services are medically necessary, properly documented, and billed correctly. This position will identify billing and coding issues and ensure compliance with state and federal regulations.
Key Responsibilities:
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Review medical records and paid claims for accuracy and compliance.
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Identify issues such as upcoding, duplicate billing, unbundling, and incorrect billing.
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Conduct retrospective case reviews and document findings.
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Use ICD-10, CPT, and HCPCS coding references to validate claims.
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Prepare reports, provider correspondence, and case documentation.
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Track case activity and provide updates to management.
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Participate in meetings and discussions with providers and internal stakeholders.
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Assist with complaints, tips, and investigations as needed.
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May be required to provide testimony in legal proceedings.
Qualifications:
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Associate’s degree in Health Services Management OR 2 years of healthcare management experience, preferably in an outpatient setting.
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Strong attention to detail and ability to interpret rules and regulations.
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Excellent written and verbal communication skills.
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Proficiency with Microsoft Office, especially Excel.
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Ability to prepare professional reports and correspondence.
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Ability to handle confidential information.
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Strong organizational and analytical skills.
Benefits:
Benefits are available to full-time employees after 90 days of employment.
A 401(k) with company match is available after 1 year of service.
INDKS