Registered Nurse Case Appeals Job in Woodland Hills, California US
Registered Nurse Case AppealsNurse Appeals – 3-6 month contract in Woodland Hills SUMMARY Responsible to investigate and process grievances and appeals requests from members and providers. MAJOR DUTIES AND RESPONSIBILITIES Conducts investigations and reviews of member and provider grievances and appeals. Reviews prospective, concurrent or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes essential medical information for medical director, consultants and other external review. Prepares recommendations to either uphold or deny appeal and forwards Read more […]
July 7, 2008
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