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Appeals Coordinator - CN9101NSMagellan Health Services - Miami, FLCoordinate appeals process as assigned, attends to risk manage- ment issues associated with case management and processes ap- peal requests. ESSENTIAL FUNCTIONS: (Tasks critical to completion of daily workload) A. Maintains a caseload and monitors day to day compliance of appeal decision time frames. B. Reviews inpatient and outpatient medical records for com- pleteness and determines administrative or clinical appeal; assigns clinical appeals to Physician Advisors for medical necessity reviews. C. Enters all data related to appeals and case reviews into a database. D. Prepares and presents information on appeals to panels second-level multi-disciplinary committee. E. Participates in data gathering and analysis of reports re- garding appeal activity as well as preparing for... See job listing >30+ days ago from Magellan Health Services Inc - Save - Block - Flag - More Tools...
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Magellan Health Services
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Headquarters:
55 Nod Rd
Avon, CT 06001
Phone: 860-507-1900
http://www.magellanhealth.com - Line of Business: Provider Of Psychiatric Services
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Key Numbers:
Company Type Public (MGLN:NMS) Company Revenue $500M+ Company Size 1000 - 5000 employees
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