Medical Review Specialist

Job Summary

A company is looking for a Medical Review Specialist III to support peer-to-peer processes within the Medical Management/Health Services team.

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 policies

Required Qualifications

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