Physician Clinical Reviewer – Pediatric Neurology
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Job Description
Physician Clinical Reviewer in pediatric neurology conducting medical reviews and collaborating with health professionals. Ensuring compliance with guidelines and regulations through documentation and communication.
Responsibilities:
- Reviews cases in which clinical determinations cannot be made by the Initial Clinical Reviewer.
- Discusses determinations with requesting physicians or ordering providers.
- Provides clinical rationale for standard and expedited appeals.
- Provides assistance and acts as a resource to Initial Clinical Reviewers as needed.
- Utilizes medical/clinical review guidelines and parameters to assure consistency in the physician review process.
- Ensures documentation of all communications with medical office staff and/or physician/provider is recorded.
Requirements:
- Education Level DO MBBS MD Required
- Experience Level 5+ years Required
- Must be eligible to work in the United States without the need for work visa or residency sponsorship.
Benefits:
- Visit our Benefits Page to review our Benefits, Incentives and Additional Compensation
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