Physician ED Claims Reviewer Job at Lorven technologies, Remote

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  • Lorven technologies
  • Remote

Job Description

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.

Desired skills:

  • 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

Job Tags

Hourly pay, Full time

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