Medical Review Support Analyst I
Portland, Oregon - Added Mar 20th, 2025
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Medical Review Support Analyst
Our client, a leading health care company dedicated to revolutionizing the industry, is looking for a Remote Medical Review Support Analyst. In this role, you will perform triage claims for clinical review and audit criteria, requests records via EMR, and processes incoming records from fax, email, and secure upload. The role may also involve sending provider request letters, handling postal mail records, inputting claim details into Facets, updating claims staff, and sending provider notification letters. If you think you’d be a good fit, we want to hear from you!
Pay Range: $20.00 - $21.85/HR
Location: Remote - Candidates MUST reside in one of the following states: Oregon, Washington, Idaho or Utah.
Contract Duration: 6 Months, Potential Temp to Hire – Benefits Eligible
Key Responsibilities for Medical Review Support Analyst:
Requirements/Qualifications for Medical Review Support Analyst:
**We are unable to accommodate corp. to corp. candidates**
About Motus Recruiting and Staffing, Inc:
Founded in 2006, Motus is an award-winning recruiting and staffing firm in the Pacific Northwest, specializing in professional services and technology solutions. We are a group of people who not only recognize the importance of representation, but actively fight for diversity, equity, and inclusion in the recruitment process. Our goal is to educate organizations on the importance of DEI when hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status.
JB/13210
Our client, a leading health care company dedicated to revolutionizing the industry, is looking for a Remote Medical Review Support Analyst. In this role, you will perform triage claims for clinical review and audit criteria, requests records via EMR, and processes incoming records from fax, email, and secure upload. The role may also involve sending provider request letters, handling postal mail records, inputting claim details into Facets, updating claims staff, and sending provider notification letters. If you think you’d be a good fit, we want to hear from you!
Pay Range: $20.00 - $21.85/HR
Location: Remote - Candidates MUST reside in one of the following states: Oregon, Washington, Idaho or Utah.
Contract Duration: 6 Months, Potential Temp to Hire – Benefits Eligible
Key Responsibilities for Medical Review Support Analyst:
- Accurately requests and obtains medical records depending on the audit.
- Prepares and sends specific record requests via facility EMR systems.
- Receives incoming records via fax, email, or secure upload, completing required fields and notes in the department database or spreadsheets.
- Prepares and sends specific record requests via facility EMR systems
- Communicates directly with Network Management regarding missing or needed records.
- Interprets claim history as needed.
- Performs at a level meeting production requirements and quality standards.
- Follows strict guidelines to ensure accuracy, timeliness, quality, and compliance with HIPAA laws/regulations, including Protected Health Information (PHI) and Personally Identifiable Information (PII).
- Contributes to department efficiency by being flexible and cross-trained on other functions as needed.
- Performs triage on all claims selected for review to determine if a claim will be reviewed according to specific criteria.
- Interprets pre-authorization determinations as needed.
- Researches and processes incoming records received via postal mail and secure upload.
- Monitors required fields and notes in the database.
- Inputs claim processing instructions or information into Facets and communicates with designated claims staff regarding the status of claims selected for review.
Requirements/Qualifications for Medical Review Support Analyst:
- High school diploma or GED, experience in healthcare field (medical office) or related formal education and at least 1 year experience or equivalent combination of education and experience.
- Remote Worker Internet Connectivity Requirement: Company computers can only connect through the following types of Internet Service Providers: CATV/Cable Modem, DSL, or Fiber. Candidates must have one of the supported ISPs to be considered. Also, contractors should be prepared to plug their computer directly into their router/modem if required by specific software applications.
- Effective communication and writing skills.
- Experience with health care systems and documentation (medical records, billing and claims); familiarity with Facets system preferred.
- Ability to investigate and research issues related to clinical programs and medical records and to take initiative to solve problems.
- Ability to work independently, to prioritize work, meet deadlines, and achieve operational standards.
- Proficiency with medical terminology. Knowledge of medical anatomy and coding preferred.
- Math aptitude and analytical ability.
- Knowledge of Blue Card, ITS processes, FEP Direct and Salesforce preferred.
**We are unable to accommodate corp. to corp. candidates**
About Motus Recruiting and Staffing, Inc:
Founded in 2006, Motus is an award-winning recruiting and staffing firm in the Pacific Northwest, specializing in professional services and technology solutions. We are a group of people who not only recognize the importance of representation, but actively fight for diversity, equity, and inclusion in the recruitment process. Our goal is to educate organizations on the importance of DEI when hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status.
JB/13210
Job ID: 13210