What is a Clinical Reviewer Job?
A clinical reviewer job is a medical profession where a specialist is responsible for reviewing medical records and providing clinical opinions based on the information provided. The role is essential in ensuring that medical claims are processed correctly, and patients receive the necessary care. Clinical reviewers work in different settings, including hospitals, insurance companies, and private healthcare organizations.
What Do Clinical Reviewers Usually Do in This Position?
Clinical reviewers are responsible for reviewing medical records, analyzing data, and providing recommendations based on their findings. They collaborate with other medical professionals, including doctors, nurses, and insurance adjusters, to ensure that patients receive the necessary care. Additionally, they may be responsible for conducting research and analyzing trends in healthcare to improve patient outcomes.
Top 5 Skills for the Clinical Reviewer Position
- Strong Analytical Skills
- Excellent Communication Skills
- Attention to Detail
- Ability to Work Independently
- Knowledge of Medical Terminology
How to Become a Clinical Reviewer Specialist
To become a clinical reviewer, you will typically need a Bachelor's degree in a healthcare-related field, such as nursing or healthcare administration. Some employers may require a Master's degree in a related field. Additionally, you will need to have experience working in the healthcare industry, preferably in a clinical setting. Some employers may also require certification from a professional organization, such as the National Association of Healthcare Quality.
Average Salary for Clinical Reviewer Jobs
According to data from the Bureau of Labor Statistics, the median annual salary for medical and health services managers, which includes clinical reviewers, is $100,980. However, salaries can vary based on factors such as location, experience, and employer.
Roles and Types of Clinical Reviewer Jobs
Clinical reviewers can work in different settings, including hospitals, insurance companies, and private healthcare organizations. Some of the roles and types of clinical reviewer jobs include:
- Medical Claims Reviewer
- Utilization Review Nurse
- Clinical Research Coordinator
- Quality Management Coordinator
- Clinical Documentation Specialist
Locations with the Most Popular Clinical Reviewer Jobs in the USA
Clinical reviewer jobs are available across the United States, but some locations have more opportunities than others. Some of the top locations with the most popular clinical reviewer jobs include California, Texas, New York, Florida, and Illinois.
What are the Typical Tools Used in Clinical Reviewer Jobs?
Clinical reviewers use a variety of tools to perform their job duties, including electronic health record systems, medical coding software, and claims processing software. Additionally, they may use spreadsheets and other data analysis tools to analyze data and identify trends in healthcare.
In Conclusion
Clinical reviewer jobs are essential in ensuring that patients receive the necessary care and that medical claims are processed correctly. To become a clinical reviewer, you will need a Bachelor's degree in a healthcare-related field, experience working in the healthcare industry, and strong analytical and communication skills. Additionally, clinical reviewers use a variety of tools to perform their job duties, including electronic health record systems, medical coding software, and claims processing software.