Peer Review Expert

20 hours ago

Cebu City, Central Visayas, Philippines beBeeProfessional Full time $10,000 - $11,000
About the Role

Establishing a dynamic and effective Peer Review Team requires an individual with exceptional clinical knowledge, analytical skills, and strong communication abilities. We are seeking a skilled Professional to spearhead peer reviews, case consultations, and insurance interactions.

This critical role demands expertise in behavioral health documentation and thorough understanding of insurance requirements. The successful candidate will be responsible for reviewing comprehensive client charts, gathering relevant information, and maintaining up-to-date knowledge of insurance medical necessity criteria.

The ideal candidate will possess a license in clinical or medical fields, such as a Registered Nurse (RN), Nurse Practitioner (NP), Medical Doctor (MD/DO), or Licensed Therapist (LCSW, LPC, LMFT, PsyD, PhD). A minimum of 2 years' experience in behavioral health, substance use, or psychiatric care is required. Prior experience with utilization review, case management, or insurance authorization processes is highly valued.

Key Responsibilities:
  • Conduct in-depth peer reviews and clinical case consultations with insurance payers to secure continued authorization.
  • Gather relevant information from comprehensive client charts, including progress notes, psychiatric evaluations, history and physical exams, nursing assessments, daily logs, medical vitals, height, weight, and lab reports.
  • Collaborate with clinical and medical team members to ensure accurate and timely information for peer reviews.
  • Maintain a current working knowledge of insurance medical necessity criteria, such as ASAM, MCG, and InterQual.
  • Diligently document all authorization and review interactions in the Electronic Medical Record (EMR) system.
  • Participate in interdisciplinary team meetings and contribute to discussions on documentation practices that support utilization review.
Requirements:
  • This is a full-time position.
  • 100% remote work arrangement.
About Our Ideal Candidate

We seek an experienced professional with a strong background in behavioral health, exceptional analytical skills, and excellent communication abilities. If you are passionate about delivering high-quality care and have a proven track record in peer review and insurance interactions, we encourage you to apply.

This role offers a unique opportunity to join a dynamic team dedicated to providing exceptional patient care and driving innovation in healthcare.

  • Expert Peer Reviewer

    16 hours ago

    Mandaue City, Central Visayas, Philippines beBeeStructuralBiology Full time ₱4,500,000 - ₱7,000,000

    Expert Peer Reviewer WantedWe are seeking highly skilled and experienced researchers to perform peer reviews for journals and publishers.As an expert peer reviewer, you will assess the novelty of manuscripts, evaluate study design and methodology, and provide constructive feedback to authors.Required QualificationsDoctorate (PhD/MD) or equivalent advanced...

  • Clinical Microbiologist Peer Review Specialist

    19 hours ago

    Cebu City, Central Visayas, Philippines beBeeClinicalMicrobiology Full time ₱3,520,000 - ₱5,360,000

    Expert Peer Reviewer OpportunityWe are seeking researchers and experts to perform peer reviews for journals and publishers, ensuring the highest level of academic integrity and advancing knowledge in their field.Required Expertise:Doctorate (PhD/MD) or equivalent advanced degree in clinical microbiology or a related field is essential.At least two...

  • Peer Review Specialist

    1 week ago

    Cebu City, Central Visayas, Philippines RemoteRaven Full time $104,000 - $130,878 per year

    Hiring: Peer Review Specialist – Behavioral Health | $10–$11/hr | RemoteAre you a licensed RN, NP, MD/DO, or Licensed Therapist with experience in behavioral health and insurance reviews? Join us as a Peer Review Specialist, where you'll ensure clients continue receiving the care they need by securing payer authorizations, reviewing documentation, and...

  • Peer Reviewer

    20 hours ago

    Mandaue City, Central Visayas, Philippines beBeeResearch Full time ₱250,000 - ₱350,000

    Join a Community of Experts in Peer ReviewWe are seeking highly qualified researchers and experts to join our team as freelance peer reviewers.This is an excellent opportunity for professionals looking to share their expertise and contribute to the advancement of knowledge in their field.Responsibilities:Assess manuscripts for originality, novelty, and...

  • Expert Peer Reviewer

    20 hours ago

    Angeles City, Central Luzon, Philippines beBeeTransfusionMedicine Full time ₱520,000 - ₱1,030,000

    Transfusion Medicine Peer Reviewer OpportunityJob DescriptionWe are seeking a highly skilled Transfusion Medicine expert to join our team as a peer reviewer. As a peer reviewer, you will play a critical role in ensuring the quality and integrity of research published in our journals.Your primary responsibility will be to assess manuscripts submitted for...

  • Academic Peer Review Specialist

    19 hours ago

    Cebu City, Central Visayas, Philippines beBeePeerReview Full time ₱1,000,000 - ₱1,500,000

    Job OpportunityWe are seeking experienced researchers, retired researchers, and former researchers to collaborate on peer review initiatives for scholarly publications.

  • Research Expert Peer Reviewer

    20 hours ago

    Tarlac City, Central Luzon, Philippines beBeeCardiology Full time ₱500,000 - ₱700,000

    Expert Reviewer WantedWe are currently looking for researchers, retired researchers, and former researchers who can perform peer reviews for journals and publishers.You should be able to disclose your full name and affiliations with the publishers.RequirementsA doctorate or equivalent advanced degree in the subject area is required.You need at least two...

  • Leading Expert Reviewer

    20 hours ago

    Cebu City, Central Visayas, Philippines beBeeRheumatology Full time ₱900,000 - ₱1,275,000

    Job DescriptionWe are seeking a highly skilled Freelance Peer Reviewer to join our network of experts.Key Responsibilities:Assess the novelty and significance of manuscripts submitted for peer review.Evaluate the study design and methodology to ensure that research can be accurately reproduced in the future.Literature reviews: check whether manuscripts...

  • Scientific Expert for Peer Review

    19 hours ago

    Tarlac City, Central Luzon, Philippines beBeeVaccineAdjuvant Full time ₱1,500,000 - ₱2,500,000

    Expert Reviewer for Vaccine AdjuvantsWe are seeking experienced professionals to contribute their expertise in peer reviewing journals and publications.Note: You should be able to disclose your full name and affiliations with the publishers.Key RequirementsPhD or equivalent advanced degree in a relevant field.At least two publications in the last two years...

  • Independent Clinical Oncology Peer Review Specialist

    19 hours ago

    Cebu City, Central Visayas, Philippines beBeeOncology Full time ₱6,000 - ₱8,000

    Freelance Clinical Oncology Peer Reviewer JobWe are seeking highly skilled researchers, retired researchers, and former researchers to perform peer reviews for journals and publishers on a freelance basis.