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Prime Therapeutics
Overview
This role involves providing timely medical review for service requests that do not initially meet medical necessity guidelines, often interacting with requesting physicians and providers. Responsibilities include discussing determinations, providing clinical rationale for appeals, and ensuring documentation accuracy according to established guidelines.
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Compensation
$91 - $154 / HOUR
Posted
9 days ago
Bluestone Child & Adolescent Psychiatric Hospital
The UR Specialist facilitates clinical reviews for admissions and continued stay to ensure medical necessity and insurance coverage. They also manage intake inquiries and collaborate with treatment teams to communicate care plans to insurance providers.
$60,000 / YEAR
1 month ago
