
Healthcare Reviewer
2 days ago
We are seeking a skilled and experienced healthcare reviewer to assess and interpret customer needs, requirements, and medical records.
Your primary responsibility will be to review medical claims for medical necessity, ensuring that they meet the required standards. To be successful in this role, you must have a deep understanding of healthcare regulations and protocols, as well as excellent analytical and communication skills.
Key Responsibilities:
- Assess and interpret customer needs, requirements, and medical records
- Review medical claims for medical necessity
- Analyze complex medical data to make informed decisions
- Communicate effectively with customers, physicians, and other stakeholders
Requirements:
- Active PHRN and USRN Mainland License
- At least 1 year bedside experience, preferably with UR/UM experience
- Excellent analytical and communication skills
- Strong attention to detail and ability to work independently
What We Offer:
- A competitive salary package
- The opportunity to work from home
- A dynamic and supportive work environment
- Ongoing training and development opportunities
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