Medical Review Institute of America

Medical Review Institute of America, LLC (MRIoA) was incorporated in 1983. Today MRIoA is an industry leader in providing external review resources for over 800 clients nationwide. MRIoA provides review of medical, dental, behavioral health, pharmacy, vision, disability, workers' compensation, and auto claims for insurance carriers, employers, TPAs, self- administered union groups, pharmacy benefit managers, human resource consultants and departments of insurance throughout the country. MRIoA utilizes a nationwide network of board-certified physician specialists and professionals in over 133 specialties and sub-specialties of medicine. MRIoA also has reviewers in most states, offering the most extensive same-state reviewer resources available from an external review organization. MRIoA holds dual accreditation with URAC with certificates in Health Utilization Management and as an Independent Review Organization. In addition we are NCQA and SSAE 16 certified. MRIoA's goal is to render a professional, independent and unbiased opinion to assist our clients with their adjudication challenges or to provide an external source to comply with ERISA/DOL or state laws. MRIoA reviews cases prospectively, concurrently and retrospectively for: Medical Necessity, Appropriate Treatment, Experimental Procedures, Utilization Frequency, Appropriate Hospitalization, Formulary Criteria Review, Pre-Existing Conditions, Injury Causation, CPT Coding, Level of Disability, Provider Fees, Outpatient Facility Fees, and all Diagnostic Testing and Charges. MRIoA has provided state-level external review in many states since 2001. MRIoA is also contracted with hundreds of clients to offer Federal External Review under the ACA.

Medical Review Institute of America Remote
Sep 23, 2021
Full-Time Medical Review Opportunity - Remote position Medical Review Institute of America (MRIoA) is the market leader for technology-enabled utilization management (UM) and Clinical Review solutions – touching over 35M lives. For almost 40 years, MRIoA has perfected the utilization and clinical review process for payers of healthcare costs. We offer the largest, most extensive review network in the industry.   Our Medical Director opportunity provides our physicians with the advantage of working from the comfort of their own home. Utilizing a desktop computer provided for them, they will be responsible for performing clinical utilization management and peer review activities as well as clinical quality management activities. Our Medical Directors work full time and are exempt employees, (paid a salary, and not per case) and are held to strict standards of productivity, and quality, including adequate follow-through and thorough, complete...