Physician Clinical Reviewer – Orthopedics
Prime Therapeutics
part-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $90,870 - $15,433 per hour
About the role
- Reviews cases in which clinical determinations cannot be made by the Initial Clinical Reviewer
- Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax
- Provides clinical rationale for standard and expedited appeals
- Ensures documentation of all communications with medical office staff and/or physician/provider is recorded in a timely and accurate manner
Requirements
- 5+ years of experience in clinical review
- DO, MBBS, or MD degree
- Must be eligible to work in the United States without the need for work visa or residency sponsorship
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Flexible work arrangements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Soft Skills
communicationclinical rationaledocumentationtimelinessaccuracy
Certifications
DOMBBSMD