Job Title

JOB TITLE: Clinical Peer ReviewerREPORTS TO: President & CEODEPARTMENT: Peer Review CommitteeFLSA STATUS: Hourly ? Non ExemptSummary DescriptionReviews patient information to ensure treatment/service provided falls within the plan guidelines and that the service was appropriate for the condition. Reviewing for positions ? Physicians ? (OB/GYN, Internal Medicine, Family Medicine), Physician Assistant, Nurse PractitionerSpecific Responsibilities include, but are not limited to:Reviewing x-rays, patient charts and other patient records to ensure treatment/service provided is within guidelines of the plan.Review pre-authorization paperwork to ensure the intended treatment meets the treatment plan criteria and relevant program plete Peer Review Form for each chart reviewedThe list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary, if needed.Academic and Experience RequirementsGraduation from an accredited schoolValid, unexpired license to practice in Michigan (Physicians)Valid, unexpired certification to practice in Michigan (Physician Assistant, Nurse Practitioner)Successful completion /passing of background check, drug screen and credential checkOther Qualifications Desired:Ability to communicate effectively (verbal and written).Excellent organization and interpersonal skills required.Skilled in working with others in a team environment.Must be proficient in MS Office applications (Word, Excel, PowerPoint)Experience working with EMR systems- eCW preferred. Will train.ExperienceMinimum 3-5 years of experience as a Physician, Physician Assistant or Nurse PractitionerKnowledge of medical/clinical procedures, terminology, and codes.