- Zelis (St. Petersburg, FL)
- …gained, and the personal interests that shape who you are. Position Overview At Zelis, the DRG Clinical Dispute Reviewer role is responsible for the ... maintain claim review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies and Dispute Rationales +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and regulatory agencies. Essential Accountabilities: Level I + Functions as a clinical reviewer of medical records, researching and investigating complex medical ... Office of Professional Discipline and/or internal referral for quality review by the applicable business area. + Acts as...clinical consultants. + Serves as an internal auditor/peer reviewer for new clinical staff, as needed.… more