Physician ED Claims Reviewer
Lorven Technologies
Hi,
Our client is looking for an Physician ED Claims Reviewer Role for Remote below is the detailed requirement.
Job Title: Physician ED Claims Reviewer
Location: Remote
Job Description:
- Bachelor's degree in related field.
- Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity.
- Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered.
- Experience in managed care, clinical UM case reviews.
- Knowledge of claims and medical coding (CPT/HCPCS codes).
- Proficient working in various systems and applications.
- Experience/knowledge in utilization management is a plus.
- Ability to work independently in a fast paced environment.
- Strong Agile experience: user story development, requirements gathering, and portfolio management
Vacancy posted 4 days ago
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