RN Clinical Appeals Specialist (Medicaid/NCQA)

NTT DATA North America is seeking a Clinical Reviewer in Manila to perform clinical reviews related to appeals processing. You will prepare case reviews, communicate with providers, and ensure timely resolution of appeals according to NCQA standards.

The ideal candidate has 1-3 years of experience in processing appeals, holds a Registered Nurse license, and possesses strong analytical and communication skills.

Working independently and efficiently, you will contribute to improving clinical appeals processes.