Remote Lead Clinical Appeals Specialist
Centene Corporation
Centene Corporation is seeking an Appeals Liaison to act as the statewide contact for appeals, fair hearings, and external reviews. This remote role requires WA licensure and aligns with NCQA standards, with hours 8:00 am–5:00 pm PST, Monday–Friday. The role emphasizes reviewing medical necessity, preparing reviews for non-criteria cases, and coordinating with Medical Directors to justify determinations, while maintaining regulatory know-how and reporting on denials and appeals. #J-18808-Ljbffr
Vacancy posted 4 days ago
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