Licensed Clinical Validation Independent Medical Reviewer Clinical Appeals Consultant
Company: VirtualVocations
Location: Jamaica
Posted on: September 20, 2023
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Job Description:
A company is looking for an Independent Medical Reviewer -
Clinical Appeals Consultant - Clinical Validation (CV).
Key Responsibilities:
Conduct timely and comprehensive reviews of medical records to
compose convincing appeal letters based on clinical
documentation
Provide root cause analyses and performance improvement
recommendations to mitigate denials
Become proficient in utilizing proprietary software and
templates
Required Qualifications:
Graduate of accredited Nursing or Medical Discipline program with
appropriate licensure
At least three years of clinical bedside experience
At least two years of experience as a Clinical Documentation
Specialist with knowledge of clinical quality improvement
principles
Understanding of basic DRG/coding principles and CMS
rules/regulations
Subject matter knowledge and familiarity with evidence-based
inpatient guidelines and criteria
Keywords: VirtualVocations, Hempstead , Licensed Clinical Validation Independent Medical Reviewer Clinical Appeals Consultant, Professions , Jamaica, New York
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