BPM

1 open remote positions

This company specializes in processing healthcare appeals and grievances for US members and providers. The organization operates with globally distributed teams, emphasizing clinical knowledge and regulatory compliance.

USRN - A&G

7 days ago

Philippines

Investigate and process complex grievances and appeals requests from members and providers.
Perform medical necessity reviews for inpatient, outpatient, ambulatory, and ancillary services.
Prepare recommendations and generate written correspondence to providers, members, and regulatory entities.

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