Clinical - Clinical Review Clinician - Appeals - J00923
Overview
Remote
On-site
Compensation
$30-$40/hour
Job Description
Position Title: Clinical Review Clinician - Appeals
Location: Remote
Duration: 6 Months | Possibility to extend or convert
Schedule: 8-5 EST or CST time zone-weekend rotation required.
PR: $30-40.00/HR
Responsibilities:
- Team handles various types of authorization and claim review requests from various markets nationwide.
- Processing clinical reviews to ensure members have the best outcomes and access to care needed.
- Help reduce provider abrasion by processing retrospective claim reviews
Licensure
- Required: RN, LPN
Must haves:
- Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals
Nice to haves:
- Medicare Appeals Experience
Best vs. average:
- Productivity expectations are set based on the platform.
Disqualifiers:
- Not having a valid/active RN/LPN license
Top 3 must-have hard skills
- Utilization Management or Appeals review background (1 plus year)
- Medicare NCD/LCD and InterQual/Milliman Software (1 plus year)
- Retrospective claims clinical reviews (1 plus year)
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FAQs About Clinical - Clinical Review Clinician - Appeals - J00923 Jobs at Pacer Group
What is the work location for this position at Pacer Group?
This job at Pacer Group is located in stebbins, AK, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at Pacer Group?
Candidates can expect a pay range of $30–$40 per hour for this role.
What employment applies to this position at Pacer Group?
The employer has not provided this information. This may be discussed during the hiring process.
What is the process to apply for this position at Pacer Group?
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