Clinical Reviewer
2 days ago
Genex Service LLC is seeking a skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will play a critical role in ensuring that medical treatment is necessary and appropriate for patients.
Responsibilities:- Perform utilization review of medical treatment requests to determine medical necessity.
- Collaborate with healthcare providers, claims adjusters, and other stakeholders to gather relevant information for comprehensive assessments.
- Evaluate medical documentation to ensure compliance with industry standards and regulatory requirements.
- Communicate findings clearly and concisely through written reports and verbal discussions.
- Stay up-to-date on industry regulations, medical advancements, and best practices to enhance the quality of reviews.
- Associate's degree in a healthcare-related field.
- 2-3 years of utilization review experience.
- New Jersey Decision Point Review (NJ DPR) experience preferred.
Genex Service LLC offers a comprehensive benefits package, including medical, dental, vision, health savings accounts, flexible spending accounts, life and AD&D insurance, 401(k), tuition reimbursement, and more. Compensation is based on skills, experience, and education, with a range of $52,719 - $80,000 annually.
Genex Service LLC is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to building a diverse, inclusive, and authentic workplace.
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