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Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within Medicare
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation cases. - Review, organize and
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