Claims Utilization Management Reviewer

Company: VirtualVocations
Location: Saint Paul
Posted on: November 6, 2024

Job Description:

A company is looking for a Claims Utilization Management Reviewer to support retrospective claims review processes.

Key Responsibilities

Review medical claims and gather necessary records for nurse evaluation
Engage with claims and clinical review functions to identify trends and ensure compliance
Request medical records and manage authorizations in various computer systems

Required Qualifications

High School Diploma or GED
At least 1 year of experience in a medical office or claims department
Knowledge of medical terminology
Proficiency with computers and Microsoft Office programs
Ability to work flexible 8-hour shifts during normal business hours

Keywords: VirtualVocations, Eau Claire , Claims Utilization Management Reviewer, Executive , Saint Paul, Wisconsin

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