Job Description

Clinical Reviewer
Remote, California
Duration: 3 Months (Potential for extension)

Client is looking for a Clinical Reviewer to join the growing team.


Job Summary

• Utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements.
• Remote position; candidates must reside in California and hold a CA license as a Social Worker or LMFT.

Responsibilities

• Ensure accuracy and timeliness of all applicable review cases within contract requirements.
• Assess, evaluate, and manage daily workload and queues; adjust work schedules to meet departmental demands.
• Collaborate with Supervisor on quality monitoring activities.
• Maintain current knowledge of review processes and clinical practices.
• Serve as providers liaison for customer service issues and problem resolution.
• Perform all applicable review types as workload requires.
• Foster positive and professional relationships with internal and external customers.
• Attend training sessions and scheduled meetings for updated information.
• Cross-train to provide a flexible workforce that meets client/customer needs.
• Read, understand, and adhere to all corporate policies, including HIPAA Privacy and Security Rules.

Requirements

• Knowledge of medical records, medical terminology, and disease processes.
• Strong clinical assessment and critical thinking skills.
• Excellent written and verbal communication skills.

Metasys Technologies is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identify, national origin, veteran or disability status.

Job Tags

Contract work, Remote work, Flexible hours

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