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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