Job Abstract

Research and resolve written complaints submitted by consumers and physicians/providers Ensure complaint has been categorized correctly Obtain additional documentation required for case review Review case to determine if review by clinician is required Render decision for non-clinical complaints using sound, fact-based decision making Complete necessary documentation of final appeals or grievance determination using appropriate templates Communicate appeal or grievance information to members or ... more details
Search Terms: AppealsRepresentativeMicrosoftRemoteHealth

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