• Clinical Auditor : Appeals

    Healthfirst (NY)
    **Duties and Responsibilities:** + Conduct quality audits of A&G items cases grievances , pre-service appeals , and post service appeals utilizing appropriate ... required to complete the audit. + Review and investigate appeals and grievances requests to ensure all...and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or… more
    Healthfirst (05/02/25)
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