$50,602 – $83,227 a year
The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for payment supporting claims or prior authorization requests submitted to Medicare (Durable Medical Equipment, Professional, and/or Institutional) and/or Medicaid, and providing applicable education. This position applies clinical knowledge to assess and ensure services/items billed are reasonable and necessary, supported by national and local policies, are under accepted billing and coding practices, and meet standards of medical care.
Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.
This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.
Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.
Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian’s prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.
Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.
Noridian is a Federal Contractor required to comply with the Executive Order 14042 and the guidance released by the Safer Federal Workforce Task Force. This Order requires us to ensure all employees working on covered contracts are vaccinated against COVID-19 unless approved for an accommodation due to a medical condition or a sincerely held religious belief. All candidates must be fully vaccinated upon their start date or have an approved accommodation. To request an accommodation, please contact our Human Resources department at firstname.lastname@example.org.
As of December 7, 2021 the nationwide Federal Mandate has been put on hold. At this time, candidates would not be required to be vaccinated or have an approved accommodation, however if the Executive Order 14042 / Federal Mandate is deemed Legal by court rulings, candidates and employees would need to comply.
NOTICE TO COLORADO APPLICANTS:
Per Colorado’s Equal Pay Transparency Rules Act, below is the salary range for potential new hires that will be working/residing in the state of Colorado.
Colorado Salary Range: $50,602 – $83,227 per year
Other Compensation: Incentive Plan
This job will be closed 6/20/2022 at 8:00AM CST. No further applications will be considered.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)