Clinical Reviewer

Remote • Posted 1 day ago • Updated 1 day ago
Full Time
Travel Required
Remote
Depends on Experience
Fitment

Dice Job Match Score™

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Job Details

Skills

  • Customer Service
  • Collaboration
  • Communication
  • Critical Thinking
  • Privacy
  • Problem Solving
  • Training
  • HIPAA
  • Knowledge Base
  • Medical Records
  • Medical Terminology

Summary

Clinical Reviewer
Remote 
 

Responsibilities:

· Assures accuracy and timeliness of all applicable review type cases within contract requirements.

· Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department.

· In collaboration with Supervisor, responsible for quality monitoring activities.

· Maintains current knowledge base related to review processes and clinical practices.

· Functions as providers'' liaison for customer service issues and problem resolution.

· Performs all applicable review types as workload indicates.

· Fosters positive and professional relationships with internal and external customers.

· Attends training and scheduled meetings for current/updated information.

· Cross trains to provide flexible workforce to meet client/customer needs.

· Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

· Knowledge of medical records, medical terminology, and disease processes required.

· Strong clinical assessment and critical thinking skills required.

· Excellent written and verbal communication skills required

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 90718572
  • Position Id: 8952941
  • Posted 1 day ago
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