We are seeking a Medical Claims Examiner to become a part of our organization! You will review mental health payment requests for the Victim Compensation Program and identify and request any documents needed to verify and determine payment amount(s) reimbursable to the claimant and/or provider. This will work 8-10 hours per week.
The Contractor will ensure that any payment adheres to applicable Victim Compensation law and administrative rules. The Contractor will review each provider’s professional qualification(s) to determine reimbursement eligibility. In addition, the Contractor will review additional payment request supporting documentation, such as treatment plans and session summary notes, to determine if psychological treatment is directly related to the psychological injuries (trauma) suffered as a result of the crime on which the victim compensation claim is based. The Contractor will calculate any amounts reimbursable and submit to staff for the next step in payment processing. The Contractor may also assist with training(s) associated with the mental health payment process when needed.
- Correspond and interview with medical specialists, agents, witnesses, or claimants to compile information
- Take accurate and detailed statements from all involved parties
- Calculate and approve payment of claims within a certain monetary limit
- Coordinate with legal counsel in handling cases correctly
- Previous coding experience in mental health setting.
- may be an LCSW or an LPC.
- Excellent written and verbal communication skills
- Deadline and detail-oriented
MS Attorney General’s Office