Insurance Adjuster (Remote)

Certified Professional Coder/ PIP Adjuster

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients' needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers' compensation insurance carriers; third party administrators (TPAs); and government entities we serve.

We are actively hiring to expand the team and as the department grows, there may be opportunities for future advancement into leadership roles individuals who demonstrate mastery of the production role, along with a strong understanding of coding, PIP, and state regulations.

Location: Remote

FMLA: Non-Exempt, Full-Time

MUST HAVE: PIP experience with high level understanding of fee schedule guidelines in NY, NJ, FL or MI required CPC in good standing with AAPC required (may consider candidate with strong PIP experience, IE: NJ/NY PIP adjuster)

IE: CPT guidelines, CPT Assistant, Encoder Pro, 3M Software

Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds

Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes

Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement

Document review outcomes for customers in a professional easy to understand manner

Use various resources, IE: eBooks, 3M software to support reviews

Participate in conference calls as needed with customers and/or attorneys

Participate in virtual and in-person testimony or trial when needed

Assist with various special projects and other duties as assigned

Must have attention to details, ability to quickly identify errors in written reports, legal documentation

• Extensive knowledge of coding /documentation requirements
• Willingness to testify on a needed basis on behalf of customer to coding outcomes
• Willingness to travel for testimony as required
• Computer experience
• Excel experience beyond beginner
• Ability to manage time when working remotely
• Must be able to travel to Hamilton NJ office as needed
• 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.