• Medical Record Case Review Specialist

    Job ID 2019-3340
    Job Locations
    Analyst (Business, Systems, Data)
    Regular Full-Time
  • Responsibilities

    NCI: As the Medical Record Case Review Specialists III (Claims Analyst III) in Henrico, Virginia, you will have experience in working with case management of medical records, abstraction, and following policies for obtaining missing/incomplete medical record documentation. Your experience with medical records, knowledge of what constitutes required documentation in inpatient/outpatient medical records, physician office records, laboratory/radiology, and other types of medical records will provide first level expertise in clinical documentation review. ICD-10-CM/CPT-4 coding experience is also invaluable as well. Upon hire, on-the-job training will be given in our Richmond, VA office. In assuming this position, you will be a critical contributor to meeting NCI's mission: To deliver innovative, cost-effective solutions and services that enable our customers to rapidly adapt to dynamic environments.




    • Utilize medical record knowledge and experience in order to determine complete medical records.
    • Apply knowledge of ICD-10-CM and CPT-4 coding in order to determine services rendered.
    • Sort and notate medical record layouts, formats, and abstraction for a variety of medical settings.





    • LPN (Licensed Practical Nurse) and at least five (5) years of clinical or medical review experience
    • Current licensure as a LPN in one or more of the 50 states or D.C.


    • RHIA
    • Medicaid/CHIP experience
    • Previous experience with review of Medical Claims and request for additional documentation for deficient medical records.
    • Previous utilization/medical necessity review experience.
    • CPMA (Certified Professional Medical Auditor), CDIP (Certified Documentation Improvement Practitioner), RHIT (Registered Health Information Technician), CPC (Certified Professional Coder), CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist - Physician), or CCA (Certified Coding Associate) are preferred.
    • Supervision or management experience
    • Bilingual (Spanish) - Fluency in speaking, reading and understanding the Spanish language. 


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