Mitarbeiter Medizincontrolling Schwerpunkt Einzelfallprüfungsmanagement (m/w/d)
Core
Independently process outpatient and inpatient medical insurance and health fund review cases, conduct deep case analyses, and draft competent medical opinions and legally sound objection justifications.
Role type
Medical Case Review Management Specialist
Builds
Optimizes the overall case review process in collaboration with structural review management
Domain
Healthcare administration and medical billing compliance
Required skills
Medical case analysis, Medical opinion drafting, Legal objection justification, Knowledge of hospital billing regulations (ICD, OPS, DRG-PEPP, PrüfvV), Collaboration with structural review management
Preferred skills
None stated
Technologies
ICD, OPS, DRG-PEPP, PrüfvV
Responsibilities
Process outpatient and inpatient MD and health fund review cases, Conduct deep case analyses, Draft medical opinions and legally sound objection justifications, Collaborate with structural review management to optimize the overall process
Seniority
Mid-level, specialized role
