Medical Claims Review Analysts - IP
Core
Medically scrutinize and justify prescribed treatments or services to finalize medical insurance claims and pre-authorization requests.
Role type
Medical Claims Review Analyst
Builds
Finalized claims and pre-authorization decisions
Domain
Healthcare insurance / Medical Adjudication
Required skills
Medical knowledge, Claims adjudication, Regulatory compliance, NHS software systems proficiency, Policy interpretation
Responsibilities
Medically scrutinize prescribed treatments, Finalize assigned claims cases, Process pre-authorization requests, Maintain IP pre-approvals within NHS software systems, Adhere to organizational policies and regulatory authority regulations