Claims Utilization Management Reviewer

Company: VirtualVocations
Location: Saint Paul
Posted on: October 18, 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 review
Engage with claims and clinical review functions to identify trends and ensure compliance
Request medical records in a timely manner and maintain accurate data in computer systems

Required Qualifications

High School Diploma or GED
1+ years of experience in a medical office or claims department
Knowledge of medical terminology
Proficiency with computers and Microsoft Office programs
Ability to work flexible hours between 6:00 AM - 2:30 PM PST, including occasional overtime

Keywords: VirtualVocations, Minnetonka , Claims Utilization Management Reviewer, Executive , Saint Paul, Minnesota

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