RN Medical Reviewer — Health Plan Claims & Care
Bcbsms
Blue Cross & Blue Shield of Mississippi seeks an RN Medical Reviewer, FEP to perform thorough clinical reviews of Federal Employee Program pre-service requests and post-service claims for medical and medical drug services. You will determine coverage and medical necessity using established policy criteria, request necessary documentation, document decisions clearly, and monitor utilization trends for potential Care Management interventions. #J-18808-Ljbffr Bcbsms
Vacancy posted 2 days ago
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