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Clinical Review Specialist
| Details |
Country: USA
Location: GA Gainesville
Total applied: 4
Relevant Work Experience: 2+ to 5 Years
Job Type: Employee
Job Status: Full Time
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Clinical Review Specialist
Description: Clinical Review Specialist's duties are performed either in a CBU or at client site. Duties may include the following: Monitors and/or reviews medical bills for cost containment and performs audits of hospital bills or other institutional bills. Serves as liaison with the medical community. Advises CBU staff on ways to control costs and establishes community prevailing rates for medical services and supplies. Directly interacts with the bill payment team on quality, production, and training issues. Assists the Legal Departments of client organizations by providing clinical analysis of product and general liability files. Submits detailed summary and analysis of medical records and makes recommendations on the medical management of submitted cases. Graduate of an accredited nursing school.
Qualifications:
Current nurse licensure. BSN preferred. Minimum 3-5 years of relevant hospital or clinical review experience. Additional experience in insurance and bill review preferred. Excellent verbal and written communication skills required.
Salary/Benefits: Salary commensurate with experience
We recognize that talented people are attracted to companies that provide competitive pay, comprehensive benefits packages and outstanding advancement opportunities. For this reason we offer a Comprehensive Benefits Plan that includes the following: 401K and retirement plan, Accidental death & dismemberment insurance, Credit Union membership, Dental coverage, Dependent life insurance, Disability insurance, Discounts on automobile and homeowner's insurance, Employee life insurance, Long-term care insurance, Medical coverage, Paid time-off, Pay-for-Performance, Reimbursement accounts, Tuition reimbursement, Vision care coverage, and Work/Life resources.
Job Location: Gainesville, GA
Job Number: 24524BR
Company URL:
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Healthcare - Medical Records, Health IT & Informat 
