Medical Claims Review Analyst

Medical Claims Review Analyst- Complex Claim Unit Provides clinical review expertise for high dollar and complex claims, including facility and professional bills. Provides cost containment services by identifying coding and billing errors and insuring application of Medical and Reimbursement Policies. Additionally identifies cases for potential fraud and abuse and makes referrals. Major Job Responsibilities Evaluates medical information against criteria, benefit plan, coverage policies and det… This is a short preview. Tap Apply to read the full job description and apply on the employer's or recruiter's page.