Behavioral Health Appeals Clinician
VirtualVocationsEscondido, California, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Clinical Review Clinician Appeals - Behavioral Health.
Key Responsibilities
Performs clinical reviews to resolve and process appeals by analyzing medical records and clinical data
Ensures timely review and response to appeals in accordance with relevant standards
Communicates with members, providers, and other departments regarding appeals requests
Required Qualifications, Training, and Education
Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience
RN, LCSW, or LPC licensure required
Knowledge of NCQA, Medicare, and Medicaid regulations preferred
Knowledge of utilization management processes preferred
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Behavioral Health Clinician • Escondido, California, United States
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