specifications as required by funding terms and conditions. Research, compile, review and analyze data related to the appeal process... officer and Assistant Manager, Fraud Prevention and Appeals. EXPERIENCE, KNOWLEDGE, SKILLS AND ABILITIES YOU SHOULD POSSESS...
Effectiveness Data and Information Set (HEDIS) Abstractor II reviews medical records to ensure completeness, compliance... agencies. Abstracts medical record information and enters data on appropriate HEDIS forms (tool). Makes determinations...