New 
Clinical Review Clinician - Appeals
 Spectraforce Technologies | |||||||||||||||||
 United States, Arizona, Phoenix | |||||||||||||||||
 Oct 05, 2026 | |||||||||||||||||
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Job Title: Clinical Review Clinician - Appeals Duration: 06 months (Possibility for extension or conversion) Shift Schedule: 8-5 EST or CST time zone-weekend rotation required. Location: Remote- Nationally sourced. However, would like 1 candidate in AZ Responsibilities: Staff will work when there are members of the supervisor/leadership on. Cases are assigned in round robin fashion for staff to review and work. Nurses review case files, add, update or edit authorizations. Work closely with the MD team to make final decisions on cases. The clinical team works closely with their supervisors and senior clinicians on the team for support. Team does have group chats on Teams for routine questions. Team works closely together along with the coordinator team who owns end to end process on cases. Team handles various types of authorization and claim review requests from various markets nationwide. Processing clinical reviews to ensure members have the best outcomes and access to care needed. Help reduce provider abrasion by processing retrospective claim reviews.
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