Oregon Licensed Medical Claims Reviewer

Job Summary

A company is looking for a Medical Claims Reviewer to join their team.

Key Responsibilities

• Audit charts and adjudicate claims while ensuring compliance with regulations
• Review claims prior to payment and investigate inquiries regarding compliance and coding
• Work with Provider Support to resolve provider issues and ensure optimal reimbursement

Required Qualifications

• Bachelor's degree in a relevant field or four years of technical-level experience in a related role
• Technical knowledge of statutory regulations and medical terminology
• Experience in medical coding systems and billing procedures
• Knowledge of auditing concepts and principles
• Ability to work collaboratively with various teams and manage claims independently