Claims Reviewer
Company: VirtualVocations
Location: Vista
Posted on: May 10, 2025
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Job Description:
A company is looking for a Claims Reviewer to evaluate medical
claims and ensure compliance with established guidelines.
Key Responsibilities
Conducts medical claims review to assess medical necessity and
appropriateness of care
Validates medical determinations through research and prepares
cases for further review
Identifies process improvements and ensures compliance with
contract timelines for claims resolution
Required Qualifications
High School Diploma or GED
2+ years of claims review experience
Knowledge of all types of medical claims review
Keywords: VirtualVocations, La Habra , Claims Reviewer, Other , Vista, California
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