Looking for a challenging and rewarding role in the healthcare field? CAP Global Works, LLC, is seeking an experienced Medical Record Content Reviewer to join our team. If you have a sharp eye for detail, a passion for ensuring quality care, and the ability to work independently while supporting others, we’d love to hear from you!
As an Advanced-Level Medical Record Content Reviewer, you’ll play a key role in evaluating home and community-based services provided under the Medical Assistance Program. This position requires a professional with at least 3 years of experience, who can independently manage responsibilities and serve as a resource for others.
Your work will ensure the services provided meet quality standards, comply with regulations, and are supported by accurate documentation. You’ll also collaborate with nurse reviewers, physician consultants, and other stakeholders to uphold the integrity of the program.
In this role, you’ll:
- Analyze records, claims, timesheets, and reports to identify discrepancies.
- Review provider compliance with State and Federal regulations.
- Evaluate medical necessity and quality of care.
- Prepare case findings and coordinate with nurse reviewers and physician consultants.
- Manage assigned cases and maintain tracking systems.
- Conduct provider documentation reviews and participate in provider meetings and teleconferences.
- Support litigation preparation activities when required.
- Prepare correspondence, reports, and investigative findings.
- Respond to complaints and inquiries from various sources.
- Perform special projects and related duties as assigned.
To succeed in this role, you’ll need:
- A minimum of 3 years of experience in a relevant field.
- Advanced-level expertise, with the ability to perform duties independently and serve as a resource for others.
- Strong analytical and organizational skills to manage cases and maintain tracking systems.
- Excellent communication skills to prepare reports, coordinate with stakeholders, and respond to inquiries.
- A commitment to upholding the quality and integrity of medical services.
OMAP – Program Integrity
625 Forster Street
Harrisburg, PA 17120
At CAP Global Works, LLC, we are committed to making a positive impact in the healthcare industry. Our team values professionalism, collaboration, and excellence in every aspect of our work. If you’re looking for a role where you can grow your skills, contribute to meaningful work, and be part of a supportive team, this is the opportunity for you.
If this sounds like the perfect fit for your skills and experience, we’d love to hear from you! Take the next step in your career and apply today to join CAP Global Works, LLC. Together, we can make a difference.