Clinical Review Specialist

2 weeks ago

Lahore, Punjab, Pakistan beBeeClinical Full time 2,500,000 - 3,500,000
Medical Officer

We are seeking a dedicated professional to conduct prior authorization reviews for medical procedures, treatments, and medications, ensuring clinical accuracy and adherence to established protocols.

Key Responsibilities:
  • Evaluate prior authorization requests for medical necessity and appropriateness based on clinical guidelines.
  • Review supporting clinical documentation to ensure accurate assessment of requested treatments or procedures.
  • Coordinate and collaborate effectively within the internal medical team to streamline authorization decisions.
  • Maintain thorough and accurate records of all prior authorization reviews and decisions.
  • Provide clinical insights and support to team members as required.
  • Stay updated with current clinical practices and healthcare standards relevant to prior authorization.
Requirements:
  • Prior experience in prior authorization or clinical review is preferred.
  • Excellent verbal and written communication skills.
  • Ability to work effectively in a collaborative environment.
  • Strong clinical judgment and attention to detail.
Qualifications:
  • MBBS/MD degree from a recognized institution (mandatory).
  • Active and valid medical license.
  • Minimum 2 years of clinical experience.
  • Proficiency in using medical documentation tools and MS Office applications.

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