Clinical Review Expert

hace 24 horas


San Juan, San Juan, Puerto Rico Optum A tiempo completo

About the Position:

This is an exciting opportunity to join our team as a Clinical Reviewer and contribute to the accuracy and integrity of medical claims. As a key member of our team, you will be responsible for reviewing and investigating claims, identifying potential issues, and working with providers to resolve any discrepancies.

Your Key Responsibilities:

  • Clinical Review: You will review medical claims to determine their validity and accuracy, using your knowledge of clinical guidelines to make informed decisions.
  • Claims Investigations: You will investigate any issues with claims, working closely with providers and other stakeholders to ensure that claims are processed correctly.
  • Compliance: You will ensure that all claims are compliant with relevant regulations and guidelines, including state and federal laws.

What We Offer:

In return for your expertise and dedication, we offer a competitive salary and benefits package, as well as opportunities for career growth and professional development.



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