Advocacy Clinical Review Coordinator - Appeals & Utilization

Excellus BlueCross BlueShield

Excellus BCBS is seeking an Advocacy Clinical Review Coordinator I/II/III to investigate member and provider appeals, grievances, and complaints across lines of business. You will review medical necessity requests, determine appropriateness of care, and expedite cases within regulatory timeframes.

Level I–III responsibilities include compiling documentation, producing written responses, and collaborating with Medical Directors, Sales, Compliance, Vendors, and Legal to ensure accurate decisions

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Vacancy posted 20 hours ago

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