Clinical Reviewer: Elevate Medical Records

Acentra; Northern (KY); On-site; USD 39,000 - 48,000; Full time

Job summary

Acentra Health seeks a Clinical Reviewer to join our team. The role focuses on reviewing medical records for appropriateness against contract requirements and maintaining accuracy and timeliness in review processes.

Applicants should hold an active clinical license (LPN, RN, or Social Worker) and demonstrate strong clinical assessment, communication, and record-keeping skills to support quality monitoring and provider relations across contracts.

Qualifications

• Active unrestricted clinical license as LPN, RN, or Social Worker.
• Knowledge of medical records organization and terminology.
• Excellent written and verbal communication.
• Experience with medical record abstraction.

Responsibilities

• Review medical records against criteria and contract requirements.
• Ensure timeliness and accuracy of review-type cases.
• Monitor workload and adjust schedules to meet demand.
• Support quality monitoring and identify improvement areas.
• Serve as liaison for provider customer service issues.
• Participate in ongoing training and maintain updated processes.
• Cross-train to support multiple contracts as needed.
• Adhere to HIPAA and related privacy/security policies.

Skills

LPN license

Clinical assessment

Critical thinking

Written communication

Medical record abstraction

Education

Associate's degree or Practical nursing diploma

Bachelor's degree in related field (RN/SW)

Job description

Acentra Health seeks a Clinical Reviewer to join our team. The role focuses on reviewing medical records for appropriateness against contract requirements and maintaining accuracy and timeliness in review processes.

Applicants should hold an active clinical license (LPN, RN, or Social Worker) and demonstrate strong clinical assessment, communication, and record-keeping skills to support quality monitoring and provider relations across contracts.