Medical Review Specialist

Job Summary

A company is looking for a Medical Review Specialist III who will support peer-to-peer processes in medical management.

Key Responsibilities

• Manage and review Medical Director's workflow queue and adjust as needed
• Schedule peer-to-peer (P2P) meetings between Medical Directors and providers for clinical service discussions
• Ensure timely completion of P2P authorizations in accordance with regulations and policies

Required Qualifications

• High School diploma or GED required
• 2 - 4 years of related experience preferred
• Strong knowledge of medical terminology and practices preferred