. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
Policy and Milliman Care Guidelines is preferred. Experience reviewing claims and researching CPT codes or ICD-9 codes...
in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications RN...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical...
Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews by utilizing Milliman...
applying Milliman and/or Interqual guidelines required. Familiarity with medical coding, reimbursement, and insurance practices...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
on preventing and appealing denials and educates on medical necessity criteria such as InterQual and/or Milliman Care Guidelines...
of Milliman Criteria and InterQual Criteria preferred. Current BCLS certificate, preferred Pay Transparency: Chino Valley...