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Medical Review Specialist

6/28/2025

N/A

Job Summary

A company is looking for a Medical Review Specialist III to 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) discussions between Medical Directors and providers regarding clinical services
  • Ensure timely completion of P2P authorizations in compliance with regulations and internal policies
Required Qualifications
  • High School diploma or GED required
  • 2 - 4 years of related experience preferred
  • Strong knowledge of medical terminology and practices preferred
  • Authorization and call center experience preferred

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