- coordinates with healthcare providers and patients for clinical case management
- steers members to INN healthcare providers for the their medical practitioners and facilities such as hospitals, ambulatory surgery centers, home health agencies, and other ancillary providers
- reviews medical plans of the members for their coverage determination for covered and excluded services
- coordinates with US RNs and medical directors for the medical necessity of the prior authorizations of requested services of members
- checks updates, federal mandates, state mandates and requirements regarding utilization review management for compliance
“My business would not be able to go forward if it was not for them”
Gaurab - Adhikari
SEE MORE REAL RESULTSOnlinejobs.ph "ID Proof" indicates if "they are who they say they are".
It DOES NOT indicate skill level.
ID Proof scores are 0 - 99 with 99 being the best. It is calculated based on dozens of data points.
It's intended to help employers know who they're talking to is real, and not a fake identity.