Review Vacancy
TitleMedical Care Representative
Occupational CategoryHealth Care, Human/Social Services
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $55126 to $70013 Annually
Minimum Qualifications Reachable on current open competitive Civil Service list for this title, or one year of permanent competitive class service as a Medical Care Representative.
Duties Description The primary responsibilities of the Medical Care Representative (MCR) are conducted in an office setting. Medical Care Representatives act as a medical resource for case managers and assist them with setting accurate medical reserves. They review, calculate and process facility bills after matching CPT/ICD10 codes. MCR's authorize medications after review of provider medical reports. They audit prescriptions weekly for unrelated medications, high dosage or polypharmacy issues. MCR's authorize rehabilitation, in home wound care and home health care. They evaluate and monitor claimant's care provided in acute, sub-acute and rehabilitation facilities. MCR's review variance requests (provide requests to deviate from established medical treatment guidelines) and authorize treatment deemed appropriate. MCR's may manage the medical aspects of catastrophic cases; these cases may require authorization of home and vehicle modifications.
Some positions may require additional credentials or a background check to verify your identity.