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Insurance Reviewer Jobs in Iowa

Physician Reviewer Jobs
By Avalon Healthcare Solutions At , Remote
Five (5) years’ experience in healthcare delivery performing preservice reviews
Reviews preservice laboratory testing services requests for medical necessity and correct coding
Serves as a resource for information and consultation on Preservice review issues
Consults with ordering provider during Peer-to-Peer reviews
Documents decision rationale for members and providers in clear, concise and understandable language
Other duties as assigned or requested
Qa Reviewer Jobs
By ttg Talent Solutions At , Coral Springs, Fl
Accordance with good documentation practices (GDP), product specifications, process parameters and regulatory requirements.
Communicate effectively with cross functional departments to ensure on time delivery of corrections, QA review and disposition responsibilities.
Review of analytical reports to ensure that products, material, components and intermediates meet company standards and regulatory requirements.
4+ years’ experience within the pharmaceutical, biologic, medical device or regulated industry.
2+ years’ experience in a Quality Assurance/Quality Control or Manufacturing function.
1+ year batch record and analytical data review experience required.

Are you looking for an exciting new career opportunity in the insurance industry? We are looking for an experienced Insurance Reviewer to join our team! As an Insurance Reviewer, you will be responsible for reviewing and analyzing insurance policies to ensure compliance with state and federal regulations. You will also be responsible for providing recommendations to improve policy coverage and customer service. If you have a passion for the insurance industry and are looking for a challenging and rewarding career, this is the job for you!

Overview:

Insurance Reviewers are responsible for reviewing insurance policies and claims to ensure that they are accurate and compliant with applicable laws and regulations. They must have a thorough understanding of the insurance industry, its laws and regulations, and the various types of insurance policies. They must be able to analyze and interpret complex documents and make decisions based on their findings.

Detailed Job Description:

Insurance Reviewers are responsible for reviewing insurance policies and claims to ensure that they are accurate and compliant with applicable laws and regulations. They must have a thorough understanding of the insurance industry, its laws and regulations, and the various types of insurance policies. They must be able to analyze and interpret complex documents and make decisions based on their findings. They must also be able to communicate effectively with clients, insurance companies, and other stakeholders.

What is Insurance Reviewer Job Skills Required?

• Knowledge of insurance industry laws and regulations
• Ability to analyze and interpret complex documents
• Excellent communication and interpersonal skills
• Ability to make decisions based on findings
• Proficiency in computer software programs
• Ability to work independently and as part of a team

What is Insurance Reviewer Job Qualifications?

• Bachelor’s degree in a related field
• Relevant work experience in the insurance industry
• Professional certification in insurance review

What is Insurance Reviewer Job Knowledge?

• Knowledge of insurance industry laws and regulations
• Knowledge of various types of insurance policies
• Knowledge of the claims process
• Knowledge of risk management principles

What is Insurance Reviewer Job Experience?

• Previous experience in the insurance industry
• Previous experience in claims processing
• Previous experience in risk management

What is Insurance Reviewer Job Responsibilities?

• Review insurance policies and claims to ensure accuracy and compliance with applicable laws and regulations
• Analyze and interpret complex documents
• Communicate effectively with clients, insurance companies, and other stakeholders
• Make decisions based on findings
• Update and maintain records
• Monitor changes in the insurance industry