Physician ED Claims Reviewer

Responsibilities: Conduct clinical reviews of claims and utilization management authorization requests to determine clinical necessity. Perform reviews specifically for emergency department and internal medicine cases.

Requirements: Requires a US licensed physician with 3-5 years of recent clinical experience in emergency or internal medicine. Must be proficient in medical coding (CPT/HCPCS) and have experience in managed care and UM case reviews.

Key skills: Medical Coding, CPT, HCPCS, Managed Care, Clinical Review, Utilization Management, Emergency Department Medicine, Internal Medicine, Clinical Necessity Review

Keywords: Physician, ED Claims Reviewer, Medical Coding, CPT, HCPCS, Managed Care, Utilization Management, Clinical Necessity, Emergency Medicine, Internal Medicine, UM Case Reviews, Clinical Review