New Jersey Licensed Appeal Analyst RN
Company: VirtualVocations
Location: Oxnard
Posted on: September 15, 2023
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Job Description:
A company is looking for a New Jersey Licensed Appeal Analyst
RN.
Key Responsibilities:
Handle all Utilization Management medical appeal cases
Ensure timeliness guidelines are met and appeals are handled in
compliance with regulatory requirements
Assess patient's clinical need, evaluate medical services and
procedures, and participate in quality improvement program
Required Qualifications:
Active NJ/Compact license
Experience in Utilization Management Appeals
Knowledge of regulatory guidelines including NCQA, NJ State, and
CMS
Ability to review medical records and document accurately
Strong problem-solving and analytical skills
Keywords: VirtualVocations, Oxnard , New Jersey Licensed Appeal Analyst RN, Healthcare , Oxnard, California
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