RN Clinical Appeals Reviewer (Medicaid/NCQA)

NTT DATA is looking for candidates to perform clinical reviews necessary for processing appeals by reviewing medical records in accordance with NCQA standards. The ideal candidate should possess 1-3 years of experience in appeals processing and hold a Registered Nurse license.

Responsibilities include preparing case reviews, ensuring timely processing, and communicating with various stakeholders regarding appeal requests. Strong communication and analytic skills are essential. This role is based in the Philippines, specifically in Pasay.