Medical Claims Document Handling Specialist

Job Description

Job Description

ReviewWorks a Medlogix Company founded in 1989 located in Northville, Michigan.  Provides comprehensive Medical Review Services, Medical Case Management Services and Vocational Rehabilitation Services to customers that include self-insured entities, third party administrators and insurance carriers.

JOB TITLE : Medical Claims Documents Handling Specialist

POSITION TYPE : Part-time, Non-Exempt- 20 hours per week

LOCATION : Northville, MI

POSITION SUMMARY: The incumbent is responsible for the preparation and sorting of medical bills and documents for scanning either physically or electronically utilizing OnBase software. The incumbent is also responsible for critical decision making based on the company’s policies and/or customer specifications. This position also entails the distribution of documents arriving from our customers and providers through email, fax and/or U.S. Mail to all departments in ReviewWorks.

ESSENTIAL FUNCTIONS:

• Retrieve, open, and distribute USPS mail daily to the appropriate department. 
• Sort medical bills and documentation based on document type, customer specification, and company guidelines.  
• Identify requests for reconsideration and scan requests into Onbase. 
• Carefully examine document pages to ensure legibility.
• Prepare batches and assign carrier and system numbers.
• Scan bills and documentation utilizing OnBase Software. 
• Retrieve and import image files through electronic interface or customer email for scanning to SDS.
• Retrieve and import customer claim files to the AS400.
• Access fax line, dedicated emails, and FTP site to import documents for scanning to SDS and/or delivery to interoffice personnel.
• Review requests received through the ReviewWorks website (Provider Portal) and handle accordingly. 
• Review requests received and handle accordingly. 
• Scan unable to process documents and return to customer or sender based on company guidelines.
• Examine original documents through scanner image to ensure quality.
• Track emails and faxes per inner office or customer requests
• Performs additional support for Data Entry, Claims, CMB, Pending, Professional Review, and UR departments.

SKILLS AND ABILITIES REQUIRED TO PERFORM ESSENTIAL FUNCTIONS:

• Ability to multitask in a fast-paced production environment
• Attention to detail
• Ability to read, writes, speaks, and understand English well
• Ability to understand and follow written and oral instructions
• Ability to sit for long periods of time at a computer, keyboarding
• Ability to operate standard office equipment including scanner
• Ability to work independently and in a team environment 
• Possess strong verbal and interpersonal skills
• Comfortable with office operations and electronic correspondence 
• Excellent critical thinking skills
• Good organization skills

EEOC Statement:

Medlogix is an Equal Opportunity Employer. Medlogix does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, disability, national origin, veteran status or any other basis covered by appropriate law. We will continue to maintain our commitment to making all employment-related decisions based on the merit of each individual.