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Reviewer skills for your resume and career

Updated January 8, 2025
6 min read
Reviewer Example Skills
Below we've compiled a list of the most critical reviewer skills. We ranked the top skills for reviewers based on the percentage of resumes they appeared on. For example, 13.2% of reviewer resumes contained patients as a skill. Continue reading to find out what skills a reviewer needs to be successful in the workplace.

15 reviewer skills for your resume and career

1. Patients

Here's how reviewers use patients:
  • Collected surgical data and short term/long term postoperative outcome data for a population of patients following MBSAQIP definitions and methodologies.
  • Reported quarterly accounts receivables, made accommodations arrangement for patients and their families including scheduling accommodations in Hospitals in-house Hotel.

2. Healthcare

Healthcare is the maintenance or improvement of a person's health by the diagnosis and treatment of a person's injury, illness, or any other disease. Healthcare is a basic necessity of human life and is the responsibility of the country's government to ensure that each person gets healthcare. Providing healthcare is the job of certified health professionals that includes doctors, surgeons, nurses, and other physicians. Pharmaceutical companies, hospitals, dentistry, therapy, and health training all come under healthcare. Healthcare plays a vital role in the country's economy and its development.

Here's how reviewers use healthcare:
  • Provided written correspondence to applicants; educational institutions, professional healthcare boards, and state regulatory agencies.
  • Reviewed medical services of healthcare providers, verification of enrollment, eligibility and benefits.

3. Home Health

Here's how reviewers use home health:
  • Review of prior authorization for medically necessity for the Home Health Prior Authorization Unit for Disability and Community Services.
  • Manage the intake process for Home Health, set up patient account information, and facilitate face-to-face physician encounter visit.

4. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how reviewers use customer service:
  • Listened to prerecorded customer service calls to ensure that correct information was given on pricing, availability and alternate product offerings.
  • Reviewed loans to ensure compliance with bank, regulatory and investor guidelines and customer service standards and determine acceptability.

5. Excellent Time Management

Here's how reviewers use excellent time management:
  • Demonstrate excellent time management skills by meeting auditor requirements of suspense validations and production.

6. CMS

A Content Management System or CMS is computer software that works as a framework where content can be assembled and managed by using a database. CMS is an important asset in web development. This platform enables users to create, edit, collaborate on, publish and store digital content. It helps users to manage their content and modify it from a single system.

Here's how reviewers use cms:
  • Record and process claims and other required documentation in Claims Management system provided, managed, and monitored by the CMS.
  • Reviewed Medicare Set asides national submitted by various companies to determine if MSA should be accepted for CMS submission.

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7. Review Process

Here's how reviewers use review process:
  • Demonstrated proficiency in communicating with other researchers, program managers, and subject-specific professionals to optimize application review processes.
  • Assigned higher levels of responsibility including training and instructing co-workers on appraisal review process.
Select Skills To Add To Your Resume

8. Patient Care

Patient care entails the diagnosis, recovery, and control of sickness as well as the maintenance of physical and emotional well-being through the use of healthcare providers' services. Patient care is described as services provided to patients by health practitioners or non-professionals under guidance.

Here's how reviewers use patient care:
  • Provide recommendations to Center Directors or Treatment Teams about the delivery of patient care.
  • Assisted clinical staff in researching and facilitating patient care.

9. Data Collection

Data collection means to analyze and collect all the necessary information. It helps in carrying out research and in storing important and necessary information. The most important goal of data collection is to gather the information that is rich and accurate for statistical analysis.

Here's how reviewers use data collection:
  • Documented data collection regarding recall of medical devices.
  • Experience in handling Grievance and Appeals process, medical records reviews, data collection, chart abstractions, reporting and analyses.

10. Medical Terminology

Here's how reviewers use medical terminology:
  • Proofread medical documentation for accuracy in grammar, punctuation, medical terminology, and format.
  • Designed and conducted training on Medical Claim Forms, Medical Terminology, Basic Claims Processing and Compliance with CIGNA standard procedures.

11. Medical Necessity

Here's how reviewers use medical necessity:
  • Evaluated the medical necessity of inpatient hospitalizations for children and adolescents utilizing the Oklahoma Health Care Authority criteria for Medicaid reimbursement.
  • Conduct retrospective medical record reviews for urgent and emergent hospital admissions to determine medical necessity using InterQual criteria.

12. HIPAA

Here's how reviewers use hipaa:
  • Maintained confidentiality of protected health information consistent with HIPAA guidelines.
  • Complied with all HIPAA and associated patient confidentiality requirements.

13. Medicaid

Here's how reviewers use medicaid:
  • Participated in meetings with inter agencies and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process.
  • Conducted retrospective quality reviews of provider medical records for consumers of Iowa Medicaid Program and Department of Public Health.

14. PowerPoint

Here's how reviewers use powerpoint:
  • Developed innovative PowerPoint presentation used as training manual and medical reference guide for claims reviewers.
  • Developed PowerPoint training materials and memos for Prior Authorization team re: operating standards, technical steps, and MassHealth regulations.

15. CPT

CPT is a medical term that stands for Current Procedural Terminology. Whenever a procedure like surgery or diagnosis occurs or some other medical service is rendered to a patient, it is reported to the concerned physician, insurance company, or organization. The aforementioned practice is widely referred to as CPT.

Here's how reviewers use cpt:
  • Checked ICD-9, CPT Codes to ensure correct billing/examined claim rejections, edits, and pending claims for re-consideration.
  • Evaluated certain Surgeries by CPT Codes to see if procedures meet the Surgery Indicators Monitoring Criteria.
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List of reviewer skills to add to your resume

Reviewer Skills

The most important skills for a reviewer resume and required skills for a reviewer to have include:

  • Patients
  • Healthcare
  • Home Health
  • Customer Service
  • Excellent Time Management
  • CMS
  • Review Process
  • Patient Care
  • Data Collection
  • Medical Terminology
  • Medical Necessity
  • HIPAA
  • Medicaid
  • PowerPoint
  • CPT
  • QC
  • QA
  • Chart Review
  • EMR
  • Quality Standards
  • Quality Review
  • Management System
  • Federal Regulations
  • FDA
  • Windows
  • State Regulations
  • Tax Returns
  • HEDIS
  • ICD-9
  • Utilization Review
  • NCQA
  • Peer Review
  • Technical Assistance
  • Hippa
  • Medical Charts
  • DRG
  • Medical Claims
  • Appraisal Reports
  • USPAP
  • FHA
  • InterQual
  • Relevant Components
  • Clinical Trials
  • DOD
  • Anti-Money Laundering

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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