Provider Appeals Analyst

at Harvard Pilgrim Health Care
Location Wellesley, MA
Date Posted May 21, 2020
Category Provider Relations
Job Type Full-time

Description

Bachelor’s degree in Health Administration, Business Administration or related field. Uses independent judgement to escalate high dollar, medical necessity or unique cases requiring management review. Conducts research using applicable Medicare Advantage regulatory guidelines, HPHC systems documentation and provider contract terms including payment, medical and other policies....

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