Job Summary A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities Evaluates the appropriateness of codes and determine whether they meet all established program standards. Ensures that the medical records are matched appropriately to the codes and if not, obtains them. Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met. Evaluates claims for conflict of interest and criteria appropriateness. Works within established timeframes set by program parameters. Provides strong customer service skills and works closely with clients...