Job Title:

Medical Record Reviewer -

HCBS Assignment:

6+ month

Location:

Harrisburg, PA 17120

Salary:

$23/hr

Job Summary:

Seeking a candidate with experience in Health Services Management or two years' experience in healthcare management, preferably outpatient services, and will be responsible for reviewing and evaluating the services provided in the outpatient setting, quality, quantity, compensability and adequacy of documentation to support those services rendered to recipients by providers under the Medical Assistance Program. Key Responsibilities Review and analyze healthcare claims, provider billing patterns, and compliance reports. Conduct audits of outpatient services for medical necessity, quality of care, and billing accuracy. Identify issues such as upcoding, duplicate billing, unbundling, and improper claims. Utilize ICD-10, CPT, and HCPCS coding systems to validate claims. Prepare audit findings, reports, provider correspondence, and recommendations. Review medical and financial records to support investigations. Coordinate with providers, medical reviewers, legal teams, and stakeholders. Assist with complaint investigations and compliance activities. Maintain accurate case documentation and tracking records. Qualifications Associate's Degree in Health Services Management OR 2+ years of healthcare management/compliance experience. Preferred experience in outpatient healthcare, claims auditing, utilization review, Medicaid/Medical Assistance, or provider compliance. Knowledge of

ICD-10, CPT, HCPCS

coding and medical billing practices. Strong analytical, report writing, and communication skills. Proficiency in Microsoft Office, especially Excel. Who We Are? Since 2001, InfiCare has been providing contract and direct hire staffing services to its clients across the US. InfiCare Health awarded the Gold Seal Accreditation from The Joint Commission. Reference links below are company websites: https://inficarehealth.

com/press-releases/ https:

//www.greatplacetowork.com/certified-company/7037388 https://www.inc.com/profile/infiCare #IND2

Pay:

$22.00 - $23.00 per hour

Work Location:

In person