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Weekend Chiropractic Clinical Reviewer Jobs (NOW HIRING)

MedRisk

Clinical Reviewer

Washington, DC · On-site

Appropriately refers cases for review by a physician, chiropractor, or other peer reviewer as required, providing case documentation and clinical recommendations. * Serves as a clinical resource and ...

New

Medata Inc.

$80 - $90/hr

Appropriately refers cases for review by a physician, chiropractor, or other peer reviewer as required, providing case documentation and clinical recommendations. * Serves as a clinical resource and ...

New

Belville and Associates Chiropractic Clinic

Be Seen First

Chiropractic Assistant

Oshkosh, WI · On-site

$15 - $20/hr

... · Reviews paperwork to ensure accuracy and completion, and explain any required procedures to ... Clinical Duties · Escorts patient to appropriate room. · Keeps rooms clean and organized. · Upon ...

Connect Chiropractic

Chiropractic Assistant

Milwaukee, WI · On-site

$18 - $25/hr

You finish up your assisting duties by reviewing x-rays and going over the financials. As a team ... Always eager to help where you're needed, you work two weekends a month at community outreach ...

Connect Chiropractic

Chiropractic Assistant

Wauwatosa, WI · On-site

$18 - $25/hr

You finish up your assisting duties by reviewing x-rays and going over the financials.As a team ... Always eager to help where you're needed, you work two weekends a month at community outreach ...

Connect Chiropractic

Chiropractic Assistant

Wauwatosa, WI · On-site

$18 - $25/hr

You finish up your assisting duties by reviewing x-rays and going over the financials. As a team ... Always eager to help where you're needed, you work two weekends a month at community outreach ...

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Weekend Chiropractic Clinical Reviewer information

What is the difference between Weekend Chiropractic Clinical Reviewer vs Chiropractic Claims Specialist?

AspectWeekend Chiropractic Clinical ReviewerChiropractic Claims Specialist
Required CredentialsChiropractic license, clinical review certificationChiropractic license, claims processing certification
Work EnvironmentHealthcare facilities, insurance companiesInsurance companies, healthcare billing departments
Employer & Industry UsageInsurance providers, healthcare organizationsInsurance companies, billing firms
Common Search & Comparison IntentUnderstanding clinical review roles in chiropractic careClaims processing and insurance reimbursement roles

The Weekend Chiropractic Clinical Reviewer primarily focuses on evaluating chiropractic claims for accuracy and compliance, often working in healthcare or insurance settings. In contrast, a Chiropractic Claims Specialist handles billing, claims submission, and reimbursement processes. While both roles require chiropractic credentials, their daily tasks and work environments differ, catering to different aspects of the insurance and healthcare industry.

What cities are hiring for Weekend Chiropractic Clinical Reviewer jobs?

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What are the most commonly searched types of Chiropractic Clinical Reviewer jobs?

The most popular types of Chiropractic Clinical Reviewer jobs are:

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States with the most job openings for Weekend Chiropractic Clinical Reviewer jobs include:

Weekend Chiropractic Clinical Reviewer jobs near you

Clinical Reviewer

MedRisk

Washington, DC • On-site

Other

This job post has expired today. Applications are no longer accepted.

MedRisk rating

8.0

Company rating: 8.0 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

126th of 500 rated business services

Job description

Clinical Reviewer And Tele-Services Clinician

A Clinical Reviewer and Tele-Services Clinician is responsible for reviewing medical records, patient information, and treatment plans to ensure compliance with clinical guidelines and standards. They also provide tele-services, such as telemedicine or teletherapy, to patients remotely. This role requires strong clinical knowledge, excellent communication skills, and the ability to make informed decisions regarding patient care.

Primary Duties & Responsibilities

  • Tele-services
  • Applies MedRisk's telerehabilitation and consultation program inclusion guidelines to assigned cases to determine eligibility and appropriateness.
  • Executes PT/OT evaluation and treatment consistent with telerehabilitation clinical guidelines.
  • Executes OT/OT telephonic consultation consistent with program's guidelines.
  • Documents telerehabilitation visits and consultation in a manner consistent with company policies and department procedures.
  • Performs telephonic outreach to patient, in-clinic provider, payor and physician when needed, or as requested.
  • Documents all communications with case stakeholders (adjusters, case managers, in-clinic providers.)

Clinical Review

  • Initiates review for requested service upon system referral (or referral from non-clinical staff)
  • Review types include Utilization Review and Continued Authorization (provide documented recommendations to adjusters and Nurse Case Managers based on use of appropriate guidelines.)
  • Reviews each case, and formulates recommendations through use of established medical criteria and clinical judgment and communicates case recommendations and potential appeal options as appropriate.
  • Reviews initial evaluation and all clinical documentation against APTA standards, applicable state regulations and relevant treatment guidelines.
  • If necessary, contacts the treating practitioner for additional information or clarification.
  • If necessary, consults with the Medical / Clinical Director or other licensed health professional in the same licensure category or with the same clinical education as the ordering provider.
  • As identified, conducts ongoing review(s) of active cases regarding the need for continued services or treatment
  • Submits supportive research relevant to peer review and best evidence practice patterns.
  • Documents all pertinent clinical patient / case file information and actions into case notes.
  • Appropriately refers cases for review by a physician, chiropractor, or other peer reviewer as required, providing case documentation and clinical recommendations.
  • Serves as a clinical resource and provides oversight of non-clinical personnel and identifies training needs and communicates to the appropriate supervisor / manager.
  • Complies with all established policies and procedures
  • Attends meetings and trainings.
  • Meets quality management standards.
  • Performs activities within the scope of professional licensure.
  • Completes other duties and projects as assigned.

Qualifications

  • Must be an appropriate health professional and possess an active professional relevant license
  • Professional experience in providing direct patient care
  • Experience in utilization review, case management, quality improvement and/or managed care is desired
  • Excellent verbal and written communication skills
  • Organizational skills, prioritization, problem-solving and decision-making skills are required
  • Ability to multi-task in a fast paced environment
  • Must be computer literate and be able to use the keyboard accurately.
  • Experience with Microsoft Office and review applications is desired

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