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Clinical Review Processor Jobs in Iowa

Clinical Review Coordinator - National Remote
By Optum At , Dallas, 75202
2+ years of Case Management experience
Experience in acute care, rehab, OR skilled nursing facility environment
Ability to work effectively in a self- management environment
Support new delegated contract start - up to ensure experienced staff work with new contracts
Perform other duties and responsibilities as required, assigned or requested
3+ years of clinical experience
Medical Review Nurse (Government Outpatient Clinical Focus)
By Performant Financial Corporation At , Remote
Experience with utilization management systems or clinical decision making tools such as Medical Coverage Guidelines (MCG) or InterQual.
Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse
Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits
Strong preference for experience performing utilization review for an insurance company, Tricare, MAC or organizations performing similar functions
Experience with ICD-9, ICD-10, CPT-4 or HCPCS coding.
Knowledge of insurance programs program, particularly the coverage and payment rules.
Clinical Laboratory Processor Jobs
By Skagit Regional Health At , Mount Vernon, 98273, Wa $30.10 an hour

Six (6) months previous hospital lab experience preferred.

High School graduate or GED required.

Care Review Processor Jobs
By Molina Healthcare At , , Ia $13.55 - $26.42 an hour

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees:

Are you looking for a job that will allow you to use your medical knowledge and experience to help improve patient care? If so, then a Clinical Review Processor position may be the perfect fit for you! As a Clinical Review Processor, you will be responsible for reviewing medical records and making sure they are accurate and up-to-date. You will also be responsible for ensuring that all medical information is properly documented and that all patient care is in compliance with applicable regulations. If you are looking for a rewarding career that will allow you to make a difference in the lives of patients, then this is the job for you!

Overview:

A Clinical Review Processor is responsible for reviewing and processing clinical data to ensure accuracy and compliance with established standards. They are responsible for verifying the accuracy of clinical data and ensuring that all data is properly documented and stored. They also review and analyze clinical data to identify trends and patterns that may be of interest to healthcare providers.

Detailed Job Description:

A Clinical Review Processor is responsible for reviewing and processing clinical data to ensure accuracy and compliance with established standards. They are responsible for verifying the accuracy of clinical data and ensuring that all data is properly documented and stored. They also review and analyze clinical data to identify trends and patterns that may be of interest to healthcare providers. They must be able to interpret and analyze data to identify any discrepancies or errors. They must also be able to communicate effectively with healthcare providers and other stakeholders to ensure that all data is accurate and up to date.

What is Clinical Review Processor Job Skills Required?

• Knowledge of medical terminology and clinical data
• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office Suite
• Ability to work with large amounts of data
• Attention to detail and accuracy

What is Clinical Review Processor Job Qualifications?

• Bachelor’s degree in a related field
• Previous experience in a healthcare setting
• Knowledge of medical coding and billing
• Knowledge of HIPAA regulations

What is Clinical Review Processor Job Knowledge?

• Knowledge of medical terminology and clinical data
• Knowledge of medical coding and billing
• Knowledge of HIPAA regulations
• Knowledge of data analysis and reporting

What is Clinical Review Processor Job Experience?

• Previous experience in a healthcare setting
• Experience working with large amounts of data
• Experience with data analysis and reporting

What is Clinical Review Processor Job Responsibilities?

• Review and process clinical data to ensure accuracy and compliance with established standards
• Verify accuracy of clinical data and ensure that all data is properly documented and stored
• Review and analyze clinical data to identify trends and patterns
• Interpret and analyze data to identify any discrepancies or errors
• Communicate effectively with healthcare providers and other stakeholders to ensure that all data is accurate and up to date
• Maintain accurate records and documentation of all clinical data