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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical review and tele-services, ensuring compliance with clinical guidelines while providing telemedicine and teletherapy. Proficient in patient care, documentation, and communication with stakeholders in a fast-paced environment.
Highest-signal resume keywords
Clinical ReviewTelemedicineUtilization ReviewPatient CareMicrosoft Office
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
TeletherapyPT/OT EvaluationTreatment PlanningMedical Record ReviewClinical Judgment
Soft Skills
Verbal CommunicationWritten CommunicationOrganizational SkillsProblem-SolvingDecision-Making
Tools & Technologies
Review ApplicationsTelehealth Platforms
Certifications & Qualifications
Active Professional License
Industry Keywords
Case ManagementQuality ImprovementManaged CareTelerehabilitationClinical Guidelines
About the role
Key responsibilities & impact- A Clinical Reviewer and Tele-Services Clinician is responsible for reviewing medical records, patient information, and treatment plans to ensure compliance with clinical guidelines and standards.
- Provide tele-services, such as telemedicine or teletherapy, to patients remotely.
- Applies MedRisk's telerehabilitation and consultation program inclusion guidelines to assigned cases to determine eligibility and appropriateness.
- Execute PT/OT evaluation and treatment consistent with telerehabilitation clinical guidelines.
- Document telerehabilitation visits and consultation in a manner consistent with company policies and department procedures.
- Perform telephonic outreach to patient, in-clinic provider, payor and physician when needed, or as requested.
- Document all communications with case stakeholders (adjusters, case managers, in-clinic providers).
- Initiates review for requested service upon system referral.
- Reviews each case and formulates recommendations through use of established medical criteria and clinical judgment.
- Contacts the treating practitioner for additional information or clarification, when necessary.
- Conducts ongoing review(s) of active cases regarding the need for continued services or treatment.
- Complies with all established policies and procedures.
- Attends meetings and trainings.
Requirements
What you’ll need- Must be an appropriate health professional and possess an active professional relevant license
- Professional experience in providing direct patient care
- Experience in utilization review, case management, quality improvement and/or managed care is desired
- Excellent verbal and written communication skills
- Organizational skills, prioritization, problem-solving and decision-making skills are required
- Ability to multi-task in a fast paced environment
- Must be computer literate and be able to use the keyboard accurately.
- Experience with Microsoft Office and review applications is desired
Benefits
Comp & perks- 🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account MedRisk Website LinkedIn All Job Openings 1001 - 5000 employees Founded 1994 ⚕️ Healthcare Insurance 🤝 B2B ☁️ SaaS Healthcare Insurance
- B2B
- SaaS MedRisk is a managed care organization that specializes in improving recovery and payment integrity for workers' compensation and occupational injury cases. The company combines clinical triage, scheduling, patient engagement, network management, and analytics to connect patients with appropriate care, streamline authorizations, and deliver secure electronic payments. MedRisk provides services and technology platforms for payers, providers, and patients to optimize spending, ensure compliance, and translate data into actionable insights. Clinical Reviewer 🔥 3 hours ago 🏢 – Onsite 💵 $80k - $90k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🔍🏥 Medical Reviewer 🦅 H1B Visa Sponsor Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
- A Clinical Reviewer and Tele-Services Clinician is responsible for reviewing medical records, patient information, and treatment plans to ensure compliance with clinical guidelines and standards.
- Provide tele-services, such as telemedicine or teletherapy, to patients remotely.
- Applies MedRisk's telerehabilitation and consultation program inclusion guidelines to assigned cases to determine eligibility and appropriateness.
- Execute PT/OT evaluation and treatment consistent with telerehabilitation clinical guidelines.
- Document telerehabilitation visits and consultation in a manner consistent with company policies and department procedures.
- Perform telephonic outreach to patient, in-clinic provider, payor and physician when needed, or as requested.
- Document all communications with case stakeholders (adjusters, case managers, in-clinic providers).
- Initiates review for requested service upon system referral.
- Reviews each case and formulates recommendations through use of established medical criteria and clinical judgment.
- Contacts the treating practitioner for additional information or clarification, when necessary.
- Conducts ongoing review(s) of active cases regarding the need for continued services or treatment.
- Complies with all established policies and procedures.
- Attends meetings and trainings. 🎯 Requirements
- Must be an appropriate health professional and possess an active professional relevant license
- Professional experience in providing direct patient care
- Experience in utilization review, case management, quality improvement and/or managed care is desired
- Excellent verbal and written communication skills
- Organizational skills, prioritization, problem-solving and decision-making skills are required
- Ability to multi-task in a fast paced environment
- Must be computer literate and be able to use the keyboard accurately.
- Experience with Microsoft Office and review applications is desired Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs