Medical Claims Expert

2 days ago


Bellevue, Washington, United States Dane Street Full time
Job Summary

This Physician Reviewer position involves utilizing clinical expertise to review insurance appeals and claims, ensuring compliance with client-specific policies and nationally recognized guidelines. The ideal candidate will have strong analytical skills, attention to detail, and excellent communication abilities.

Main Responsibilities
  • Conduct thorough reviews of medical records and address client questions using relevant criteria.
  • Develop clear, concise rationales for determinations, including adequate supporting documentation.
  • Prioritize case reviews to meet deadlines and ensure timely completion.
  • Maintain professional licensure and certification requirements.
  • Participate in ongoing training and professional development.
Work Environment

Dane Street values flexibility and autonomy, offering a per-case compensation structure for its reviewers. This setup allows for customization of schedules and caseloads, accommodating individual needs and preferences. Additionally, we offer support for travel expenses and assistance in obtaining necessary certifications.



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