Clinical Reviewer Job at HireTalent, Mc Lean, VA

c1RKT3prZzR3WGpHMGVOKzZQWjliUXg3
  • HireTalent
  • Mc Lean, VA

Job Description

Clinical Reviewer

The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements. Position is remote however candidates must reside in California and they need to have an active California license as a LCSW OR LMFT OR LPCC OR Licensed Social Worker.

Duties & 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.
  • Knowledge of medical records, medical terminology, and disease processes required.
  • Strong clinical assessment and critical thinking skills required.
  • Excellent written and verbal communication skills required.
HireTalent

Job Tags

Contract work, Remote work, Flexible hours

Similar Jobs

Metropolitan Life Insurance Company

Director, AI Risk Management Job at Metropolitan Life Insurance Company

 ...Posting Location:Bridgewater, New Jersey Working Schedule Full-Time Work Arrangement...  ...business growth. Join us in advancing MetLifes legacy of trust through exemplary risk...  ...voluntary insurance products including auto and home, pet, critical illness, hospital... 

My Teacher Limited

Online english teacher Job at My Teacher Limited

In order to teach English with us, you must:- Have a big smile, a passion for teaching & love for kids- Speak English at an idiomatic...  ...*- Plus, ESL/teaching experience preferred To provide the online 1V1 english teaching, you need be familar with classin app and... 

The Montevista at Coronado

PRN Resident Assistant Job at The Montevista at Coronado

 ...maintain a safe environment for all employees, residents, families, and visitors, Stellar strongly encourages its employees to receive an FDA-approved COVID-19 vaccination, as well as any subsequent booster doses, as recommended by the Centers for Disease Control and... 

HealthYes Staffing Network

Locum Tenens Hospitalist Pittsburgh PA area Job at HealthYes Staffing Network

 ...Job Description Job Description HealthYes is speaking with Hospitalists open to locum tenens coverage in the Pittsburgh area. These are active inpatient assignments with defined block scheduling and potential for extension. Opportunity Overview ~ Inpatient... 

NDT.org

Rope Access Technician Job at NDT.org

NVI is seeking experienced Rope Access Radiography Technicians to join our team supporting a longterm opportunity at the Flint Hills Refinery in Corpus Christi, Texas. Candidates will perform industrial radiographic inspections in refinery and industrial environments using...