Role: Physician ED Claims Reviewer
- Required skills: 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
Thanks & Regards,
Sriram Chaganti
Talent Acqusition Specialist | Vivid Soft Global Inc.
Email: [email protected]
Pay: $40.00 - $45.00 per hour
Experience:
- clinical experience in emergency dept medicine: 3 years (Required)
- managed care, clinical UM case reviews. : 3 years (Required)
License/Certification:
- Physician with an active US licensed (Required)
Work Location: In person
