About the role
Actively looking to hire multiple RNs that are looking for a HEDIS role. This role is starting in November - must have at least 3 seasons of HEDIS completed as well as an active RN license. LPNs are not being considered at this time. Responsibilities Review clinical data and documentation to determine claim payment decisions based on internal policies and National Committee for Quality Assurance (NCQA) guidelines. Evaluate denied claims to determine whether to overturn or uphold the denial, and…
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