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Physician ED Claims Reviewer

Role overview

Qualifications

  • US licensed physician
  • Experience in medical coding (CPT/HCPCS)
  • 3-5 years clinical experience in emergency department medicine or internal medicine
  • Experience in managed care and clinical UM case reviews

Responsibilities

  • Conduct clinical review of claims and UM authorization requests for clinical necessity
  • Utilize knowledge of claims and medical coding
  • Work independently in a fast-paced environment
  • Operate proficiently in various systems and applications

Key facts

Hard skills

About the company

Vytwo logo

Vytwo

  • Digital Transformation Consulting
  • Scaleup
  • 201–500
Vytwo Technologies is a globally recognized enterprise applications integrator. We are experts in providing IT consulting and business services for mid to large level organizations. We offer a complete range of software and consulting services such as business-technology consulting, Internet and e-business consulting, system integration, custom application development, re-engineering and sustenance. We provide and harness innovative management consulting and information technology solutions, to leverage technology in current e-business stipulated economy. We understand and help you gain recognition of how to move your business forward in this competitive space, and then we create and implement the solutions necessary to turn concepts into reality. Our company is uniquely positioned and has a proven history of ability to foresee market trends and introduce high quality products faster than any of its competitors. In a world where excellence in execution is the key to success, Vytwo Technologies has an enviable record of completing 92% of its projects on schedule. Vytwo Technology's well-defined processes and a strong "Body of Knowledge" enables the company to capture effectively the best practices of every project implemented.

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Job description

Role: Physician ED Claims Reviewer
Duration: 12 months

Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity.
Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered. Experience in  managed care, clinical UM case reviews. Knowledge of claims and medical coding (CPT/HCPCS codes). Proficient working in various systems and applications.
Desired skills: Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment.

This is a remote position.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.




Vytwo Technologies is a global leader in enterprise application integration, delivering end-to-end IT consulting and business services for mid to large-scale organizations.
We offer a comprehensive suite of solutions including business and technology consulting, Cloud,e-business and digital transformation services, system integration, custom application development, re-engineering, and long-term application support.

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