Responsibilities Audits Outpatient and Specialty Claims: Utilizes medical chart coding principles and client... in a variety of outpatient and specialty review types. Adherence to official coding guidelines, coding clinic determinations...
Overview Now hiring a Utilization Management Nurse Specialist Albuquerque Metro Residents Only. Performs clinical... review to ensure that services rendered to members meet clinical criteria and are delivered in the appropriate setting...
clinical review to ensure that services rendered to members meet clinical criteria and are delivered in the appropriate setting.... Utilizes clinical skills to to coordinate, document and communicate all aspects of the utilization/benefit management program...