Unknown Company

Remote Clinical Appeals Specialist

enola, pa • Posted 1 weeks ago
Remote Full Time Bio & Pharmacology & Health

PAM Health is seeking a Clinical Appeals Analyst (Remote) to support the Corporate Director of Appeals Management. The role conducts comprehensive analytic review of clinical documentation and completes the appeal process, writing sound letters to support the appeal.

Responsibilities include reviewing records, leveraging InterQual/Milliman criteria, developing evidence-based arguments, and preparing data analytics for leadership. Travel may be required for hospital discussions as needed.

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