Clinical Appeals Specialist

NTT DATA, Inc. seeks a professional in Manila, Philippines, to perform clinical reviews and process appeals by evaluating medical records. This role requires knowledge of appeals processing, NCQA standards, and Medicaid regulations.

The ideal candidate must have 1–3 years of experience in utilization management and possess an RN license. Strong analytical skills and good communication abilities are essential, alongside a willingness to work during US daytime hours.