Clinical Appeals Manager
management including InterQual and Milliman standards. Working knowledge of billing codes, Revenue Codes, CPTs, NCD/LCDs...
management including InterQual and Milliman standards. Working knowledge of billing codes, Revenue Codes, CPTs, NCD/LCDs...
use of clinical criteria sets and clinical pathways, such as MCG ( Milliman Care Guidelines) , Interqual® or others. (Preferred...
Experience in use of Milliman/InterQual criteria Registered Nurse (RN) NYS license required PRI/Screen certification strongly...
Experience in use of Milliman/InterQual criteria Registered Nurse (RN) NYS license required PRI/Screen certification strongly...
coding procedures, InterQual criteria, Milliman Care Guidelines( MCG), Perspective Payment System and medical terminology...
Experience in use of Milliman/InterQual criteria Registered Nurse (RN) NYS license required PRI/Screen certification strongly...
. Proficient in Allscripts EMR, Allscripts CM software program, Milliman Care Guidelines (MCG), IDX and 3M within 6 months....
Excellent communication and leadership skills;advanced knowledge of medical necessity reviews, Milliman and Interqual criteria...
, PowerPoint) Proficient with medical necessity criteria including InterQual, Milliman guidelines. Strong managerial skills...
medical necessity and appropriateness by referencing regulatory mandates, contracts, benefit information, Milliman Care...