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Utilization Review/Precert Nurse, Appeals Specialist
Highly trained and experienced utilization review and precertification nurse who has advanced experience within the Medicare/Medicaid arena and knowledge of NCQA guidelines and processes within the managed care realm.
Admissions Director
About Me
Industry: |
Healthcare & Medical |
|---|---|
Occupation: |
Admissions Director |
Highlights: |
Over 20 years experience in Medicare, Medicaid utilization review, peer review monitoring for quality assurance, medical record review, coding. |
Ideal Companies: |
Cigna, Aetna, United Health Insurance Company, Blue Cross Blue Shield, any managed care HMO. |
Education level: |
Trade School |
Will Relocate: |
Yes |
Location: |
Memphis, TN |
Major Responsibilities
Was responsible for the coordination/management of medical care surrounding worker's compensation injuries. Worked with the adjuster to promote return to work as quickly as possible.
