Quality Assurance, Utilization Review, or Case Management

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Job TITLE Job LOCATION DATE Posted
Medical Necessity ReviewerPortland, Oregon05/24/2012

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Medical Necessity Reviewer - Portland, OR
Description: Resolves, audits, and processes claims for clinically related issues to ensure accuracy of claims payment, in coordination with the Claims Administration Department.Essential Functions:- Responsible for reviewing, processing, and auditing claims for payment and appropriateness of charges and pursues adjustments as warranted.- Screens, audits, and processes claims of specific criteria for appropriate payment.- Establishes ...
Reference Code: 137511

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