California Licensed Medical Reviewer

Job Summary

Providing laboratory subject-matter expertise, the full-time California Licensed Medical Reviewer will review laboratory-related claims, Treatment Authorization Requests (TARs), and supporting documentation in a remote work environment.

Key responsibilities

• Review laboratory-related claims and evaluate services based on medical policies and coverage requirements
• Document review findings and collaborate with clinical and operational teams to resolve laboratory review questions
• Maintain knowledge of laboratory practices and ensure compliance with program guidelines and turnaround-time expectations

Required qualifications

• Minimum of two years of experience as a laboratory technician
• Completion of a Medical Laboratory Technician program from an accredited institution
• High school diploma or equivalent
• Knowledge of laboratory procedures, terminology, and documentation
• Ability to interpret laboratory-related records and claims