Clinical Reviewer

4 weeks ago


Morristown, Tennessee, United States Zelis Full time

Job Title: Clinical Reviewer - Healthcare Financial Expert

Job Summary:

Zelis is seeking a skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will be responsible for conducting in-depth reviews of medical claims to ensure accuracy and compliance with regulatory guidelines.

Key Responsibilities:

  • Conduct thorough reviews of medical claims to identify potential errors or discrepancies
  • Apply clinical knowledge and expertise to make informed decisions regarding claim reviews
  • Collaborate with cross-functional teams to resolve claim issues and improve processes
  • Stay up-to-date with changing regulatory guidelines and industry developments

Requirements:

  • 3-5 years of experience in clinical review or a related field
  • Strong clinical knowledge and expertise in healthcare finance
  • Excellent analytical and problem-solving skills
  • Ability to work independently and as part of a team

What We Offer:

  • A dynamic and supportive work environment
  • Opportunities for professional growth and development
  • A competitive salary and benefits package

About Zelis:

Zelis is a leading healthcare financial technology company that provides innovative solutions to payers, providers, and healthcare consumers. Our mission is to modernize the healthcare financial experience by bridging the gaps and aligning interests across the industry.


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