Clinical Reviewer Primary Duties
1. Conduct utilization reviews up to and including the appeal level. This includes chart screen, complete electronic worksheets, enter required information and make level one denial decisions when necessary.
2. Conduct quality and clinical study data collection reviews. This includes chart review and complete detailed electronic data worksheets.
3. Act as a resource for the administrative staff in training, problem solving and clarifying procedures. Provide technical assistance and conduct/participate in staff huddles.
4. Participate in collaborative training specific to clinical study objectives.
Schedule/Shift
Monday-Friday, 8am-5pm
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