Clinical Reviewer

Clinical Reviewer

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.