Clinical Appeals & Care Review Specialist (RN/NP)
Excellus BlueCross BlueShield
Excellus BlueCross BlueShield is seeking an Advocacy Clinical Review Coordinator to investigate member and provider appeals, grievances, and complaints across all lines of business. The role uses clinical nursing and medical expertise to review medical necessity requests and ensure timely decisions. The position collaborates with Medical Directors, Sales, Compliance, Vendors, and Legal to meet regulatory timeframes while maintaining data integrity and patient privacy. #J-18808-Ljbffr Excellus BlueCross BlueShield
Vacancy posted 2 days ago
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