Clinical Reviewer

2 days ago


Detroit, Michigan, United States Genex Services, LLC. Full time
Job Title: Utilization Reviewer

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.
Requirements:
  • Associate's degree in a healthcare-related field.
  • 2-3 years of utilization review experience.
  • New Jersey Decision Point Review (NJ DPR) experience preferred.
Benefits:

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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