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Clinical Reviewer

ICONMA, LLC

Remote, CA(remote)

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JOB DETAILS
SALARY
$16.50–$39.19 Per Hour
SKILLS
Calendar Management, Clinical Assessment, Clinical Practices/Protocols, Communication Skills, Contract Requirements, Customer Relations, Customer Support/Service, Disease, HIPAA (Health Insurance Portability and Accountability Act), Health Plan, Healthcare Providers, Knowledge Base, Medical Records, Medical Terminology, Presentation/Verbal Skills, Privacy Controls, Problem Solving Skills, Quality Monitoring, Writing Skills
LOCATION
Remote, CA
POSTED
30+ days ago
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?  
ICONMA is an Equal Opportunity Employer. All qualified applicants will receive considerationfor employment without regard to any status protected by applicable law.
 

About the Company

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ICONMA, LLC