Job Title: Clinical Review Clinician - Appeals - J00923 Address: Various, MO Job Description Review clinical appeals and make determinations based on clinical guidelines. Collaborate with healthcare professionals to assess clinical information. Document review findings and communicate outcomes clearly. Ensure compliance with healthcare regulations and standards. Participate in continuous improvement initiatives for the appeals process. Critical Information Remote position. Education/Licenses Needed Valid clinical license required. Relevant healthcare certification preferred. Benefits: Benefits are available to full-time employees after 90 days of employment. A 401(k) with company match is available after 1 year of service. This is an AI-formatted job description; recruiter confirmation required.
