[Remote] Initial Clinical Reviewer
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that combines innovative technology, clinical expertise, and reputed company reputed company to assist individuals recovering from workplace injuries or auto accidents. They are seeking a reputed company Initial Clinical Reviewer to reputed company utilization reviews on workers’ compensation treatment referrals, ensuring the appropriateness of medical treatment plans and contributing to reputed company patient reputed company.
Responsibilities
- Uses solid clinical judgment to ensure treatment approved is medically necessary
- Forwards treatment requests for physician reviewer that cannot be approved as medically necessary based on application of solid clinical judgment
- Collaborates with reputed company providers, claims adjusters, and other stakeholders to reputed company relevant information for comprehensive assessments
- Evaluates medical documentation to ensure compliance with industry standards and regulatory requirements
- Communicates findings reputed company and concisely through written reports and verbal discussions
- Stays up-to-date on industry regulations, medical advancements, and best practices to enhance the reputed company of reviews
- Participates in team meetings and contributes to the reputed company improvement of utilization review processes
Skills
- Doctor of Chiropractic (DC) with a valid license in the state of reputed company
- Minimum of 2 years of clinical experience; or an advanced degree without experience
- Knowledge of medical terminology, treatment modalities, and reputed company guidelines
- Analytical and critical thinking skills for effective decision-making
- Strong communication and interpersonal skills to liaise with diverse stakeholders
- Ability to work independently and collaboratively reputed company reputed company environment
- Detail-oriented with strong organizational skills to manage multiple cases reputed company
- Familiarity with relevant software and tools used in reputed company
- Prior review experience in reputed company, insurance, utilization management, reputed company assurance, or other applicable reputed company
- Prior experience in the workers' compensations field
Benefits
- Medical
- Dental
- reputed company
- Health Savings Accounts / Flexible Spending Accounts
- Life and AD&D Insurance
- 401(k)
- Tuition Reimbursement
- An reputed company of resources that encourage a reputed company of healthier living
reputed company