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Description
Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices.
80% of position responsibilities include:
Other responsibilities include, but are not limited to:
Position is remote, BUT candidate must live within 2-3 hours of Columbia, South Carolina.
Requirements
Full Time
Business Services
09/21/2022
11/16/2022
pme-indy.com
INDIANAPOLIS, IN
200 - 500
2005
HASKELL PORTEE
$10M - $50M
Business Services
PME is a Minority and Service Disabled Veteran Owned Business founded in 2006, that is a highly valued teaming partner in multiple states to large corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP to name a few. Additionally, we provide services in the areas of healthcare, IT, and professional services to Department of Defense and other Federal Government clients. We also are highly engaged in state work in our home state of Indiana, as well as multiple other states nationwide. We successfully leverage our abilities in Healthcare, Managed Care, IT, and Human Capital Services w...ith our flexibility and robust performance.
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The job skills required for Medical Reviewer include Microsoft Office, Written Communication, Futures, etc. Having related job skills and expertise will give you an advantage when applying to be a Medical Reviewer. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Medical Reviewer. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Medical Reviewer positions, which can be used as a reference in future career path planning. As a Medical Reviewer, it can be promoted into senior positions as a Medical Records Coding Technician that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Medical Reviewer. You can explore the career advancement for a Medical Reviewer below and select your interested title to get hiring information.