RE: Request for Licensed, Actively Practicing Audiologists to Perform Medical Necessity Peer Review
KEPRO would like you, an actively licensed and practicing audiologist, to consider joining our Peer Reviewer team to assist us with medical necessity views.
KEPRO performs peer review (specialty match) for services that do not meet medical necessity criteria resulting in denial and/or appeal. The volume of work will depend upon the volume received from KEPRO’s Medicare, Medicaid, and Commercial clients, and the specialty match required. The Peer Reviewer will always be notified by a KEPRO staff member to determine availability and turnaround time. Hourly/case rates will be dependent upon the turnaround time and specialty.
KEPRO has a credentialing and re-credentialing (every two (2) years) process very similar to hospital and health system credentialing processes. Annual mandatory compliance training is required through KEPRO’s web-based training platform. This annual mandatory training will require approximately one (1) hour of your time.
Since 1985, KEPRO has helped more than 20 million members lead healthier lives through clinical expertise, integrity and compassion. KEPRO is the Beneficiary and Family Centered Care QIO (BFCC-QIO) for more than 30 states. Headquartered in Pennsylvania, KEPRO also has offices in California, Florida, Illinois, Maine, Maryland, Massachusetts, Minnesota, Ohio, Oregon, South Carolina, Tennessee, Virginia, and West Virginia. KEPRO is URAC accredited in case management, disease management and health utilization management. We are also National Institute of Standards and Technology (NIST) and Federal Information Security Management Act (FISMA) certified.
Actively licensed and practicing audiologist, CCC-A
Telecommuting is allowed.
Additional Salary Information: Because this is NOT full time work, compensation is based on the client contract. Work is performed through secure email or fax. There is no need to commute to KEPRO offices.
About Keystone Peer Review Organization, Inc. (KEPRO)
KEPRO offers customizable care management solutions to improve the health and quality of life of our members, while reducing client costs. Our mission is to advance the quality and efficiency of health care through integrated care management solutions tailored to the needs of our customers and stakeholders.Headquartered in Pennsylvania, KEPRO is a nationally recognized provider of health care mana...gement solutions in both state and federal government, as well as commercial clients, providing prior authorization, utilization and specialty review, and case and disease management services. KEPRO is recruiting licensed, certified Speech/Language Pathologists/Audiologists with ASHA certification and at least five years work experience to perform peer case review of appeals and quality of care cases. KEPRO provides liability coverage for peer reviewer activities and the reviewer’s name will remain confidential except in instances where identification is required by law or by specific contract. We provide compensation for our reviewers based on the type of review or service being requested and/or amount allowed by the individual customer for whom the work is being performed. Compensation of services will be made within 45 days of receipt of the completed report and invoice. While we cannot guarantee any pre-established volume commitments, your approval as a credentialed peer reviewer will present you with opportunities to work with our organization in both the private and public sector. A KEPRO staff member will contact you prior to sending you a case, to determine your availability within the turnaround time constraints.For additional information, please visit KEPRO's website at https://www.kepro.comThank you for your consideration.
The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for 191,500 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students.