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Medical Review Analyst I

Medical Review Analyst I

CompanyElevance Health
LocationNorfolk, VA, USA
Salary$Not Provided – $Not Provided
TypeFull-Time
DegreesAssociate’s
Experience LevelMid Level

Requirements

  • Requires a High School Diploma and a minimum of 4 years of internal company claims processing or customer service experience; or any combination of education and experience which would provide an equivalent background.
  • Experience with medical coding and medical terminology required.

Responsibilities

  • Utilizes guidelines and review tools to analyze assigned medical records and correspondence to route to appropriate imaging and routing applications.
  • Follows department guidelines and tools to conduct reviews.
  • Reviews, analyzes and renders determinations on assigned Tier I requests.
  • Serves as a liaison between medical record management and/or service operations and other internal departments.
  • Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information.

Preferred Qualifications

  • Associate degree
  • Understanding of provider networks, the medical management process, internal business processes, and proficiency with internal local technology preferred.