About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
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
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of