Role: Physician ED Claims Reviewer
Duration: 12 months
This role involves conducting clinical review of claims and utilization management authorization requests for clinical necessity. The position is remote.
Requirements & Qualifications
- Physician with an active U.S. medical license
- Experience with medical coding (CPT/HCPCS) and managed care
- 3–5 years of recent clinical experience in emergency department medicine; internal medicine experience may be considered
- Experience in managed care and clinical UM case reviews
- Knowledge of claims and medical coding (CPT/HCPCS codes)
- Proficiency working in various systems and applications
- Ability to work independently in a fast-paced environment
- Utilization management experience is a plus
Location
Texas, US
Employment Type
Contractor
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago