Professional Review Specialist I
Adzuna
📍 Folsom, Sacramento County, United States
via Adzuna API (US)
Full-TimeOn-Site
Description
The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of bil…
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