FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Clinical Review Specialist
CorroHealthClinical Review Specialist providing support for medical reviews in revenue cycle operations. Reviewing medical records and assisting with client demands in a remote capacity.
About the role
Key responsibilities & impact- Provide clinical review support on a full-time basis to assist with an increase in inventory and client demand
- Review medical records for medical necessity, level of care, authorization compliance, and payer guideline alignment across inpatient and outpatient services
- Support timely appeal submissions and inventory management while maintaining quality and compliance standards
Requirements
What you’ll need- Active, unrestricted RN license (compact preferred)
- Minimum 4–5 years of clinical experience
- 4+ years of Utilization Review, Appeals, or Clinical Review experience
- Strong knowledge of medical necessity criteria and payer guidelines
- Experience reviewing inpatient and/or outpatient hospital claims
- Proficiency with EMRs and review platforms (Epic preferred)
- Strong written clinical documentation and time management skills
- Experience with payer appeals (medical necessity, no-auth, readmissions) (preferred)
- Familiarity with InterQual, MCG, or payer-specific criteria (preferred)
- Prior remote clinical review experience (preferred)
- Multi-client or vendor-side experience (preferred)
- Knowledge of Medicare, Medicaid, and commercial payer processes (preferred)
Benefits
Comp & perks- Remote, independent work with defined productivity expectations
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical reviewutilization reviewmedical necessity criteriapayer guidelinesinpatient claims reviewoutpatient claims reviewclinical documentationtime managementpayer appealsInterQual
Soft Skills
strong written communicationinventory managementquality complianceremote work experiencemulti-client experience
Certifications
active RN license