Clinical Reviewer Job at Akar IT services, Oregon State

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  • Akar IT services
  • Oregon State

Job Description

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Job Title - Clinical Reviewer Job Location - Remote Duration - 3+ Months Pay Rate - $43/hr. on w2 with no benefits

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The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness.

Responsibilities:

  • 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

Required Qualifications

  • Active and unrestricted Registered Nurse (RN) license for Oregon
  • Ability to be licensed for the State of Nebraska, if you don't currently hold a compact license
  • Bachelor's degree from an accredited college or university in a related field
  • 2+ years of experience in Utilization Management or Clinical Review

Preferred Qualifications

  • Case management experience
  • Knowledge of medical records, medical terminology, and disease processes
  • Strong clinical assessment and critical thinking skills
  • Excellent written and verbal communication skills

Job Types: Full-time, Contract

Pay: $43.00 per hour

Expected hours: 40 per week

Schedule:

  • 8 hour shift
  • Day shift
  • Monday to Friday

Experience:

  • Clinical Reviewer: 1 year (Required)

License/Certification:

  • RN License of Oregon (Required)
  • BLS Certification (Required)

Work Location: Remote

Job Tags

Hourly pay, Full time, Contract work, Remote work, Monday to Friday, Flexible hours, Shift work, Day shift

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