V
Vytwo
Physician ED Claims Reviewer
Remote
United States
Full Time
Mid-Senior
July 08, 2026
Emergency Medicine, Internal Medicine
Conduct clinical review of claims and UM authorization requests for clinical necessity. The role involves working with medical coding, managed care, and clinical utilization management case reviews in various systems and applications.
Key Responsibilities
- • conduct clinical review of claims and UM authorization requests for clinical necessity
Required
- • Physician with an active US licensed
- • experience with medical coding (CPT/HCPCS) and managed care
- • Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered
- • Experience in managed care, clinical UM case reviews
- • Knowledge of claims and medical coding (CPT/HCPCS codes)
- • Proficient working in various systems and applications
- • This is a remote position
Preferred
- • Experience/knowledge in utilization management is a plus
- • Ability to work independently in a fast paced environment
Role: Physician ED Claims Reviewer
Duration: 12 months
Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity.
Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered. Experience in managed care, clinical UM case reviews. Knowledge of claims and medical coding (CPT/HCPCS codes). Proficient working in various systems and applications.
Desired skills: Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment.
Duration: 12 months
Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity.
Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered. Experience in managed care, clinical UM case reviews. Knowledge of claims and medical coding (CPT/HCPCS codes). Proficient working in various systems and applications.
Desired skills: Experience/knowledge in utilization management is a plus. Ability to work independently in a fast paced environment.
This is a remote position.
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