Job Description
Role: Physician ED Claims Reviewer
- 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.
- Strong Agile experience: user story development, requirements gathering, and portfolio management
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Experience: 5-8 Years .
The expected compensation for this role ranges from $60,000 to $135,000 .
Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. Based on the position, the role is also eligible for Wipro's standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.
Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.
Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.
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