Our Client, a Leading Provider of Healthcare Delivery Systems and Solutions company, is looking for a Clinical Reviewer for their Remote/CA location.
Responsibilities:
- The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements.
- 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.
Requirements:
- Strong clinical assessment and critical thinking skills required.
- Excellent written and verbal communication skills required.
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
ICONMA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable law.