Clinical/Medical Geneticist Reviewer - Remote

Overview

This telework opportunity allows you to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.

In Short

• Utilizes clinical expertise to review insurance appeals and claims.
• Provides interpretation of medical necessity of services.
• Reviews medical records and addresses client questions.
• Ensures clear and concise rationale for determinations.
• Identifies and utilizes current criteria and resources.
• Returns cases on or before the due date.
• Makes mandated telephone calls as required.
• Maintains proper credentialing and licenses.
• Attends required orientation and training.
• Responds to quality assurance issues and audits.

Requirements

• Must be a licensed Clinical/Medical Geneticist.
• Experience in reviewing medical records and claims.
• Knowledge of evidence-based guidelines.
• Strong communication skills for client interactions.
• Ability to work independently and manage time effectively.

Benefits

• Flexible schedule and caseload.
• Work from home opportunity.
• Compensation on a per-case basis.