Work from Office
Full Time
Role Summary:
Were hiring a Utilization Reviewer with a BHMS/BDS background and 1+ year of experience in utilization review and denial management. Expertise in MCG and InterQual Guidelines is essential.
- Review clinical documentation for medical necessity
- Apply MCG and InterQual criteria
- Ensure compliance with payer and regulatory standards
- BHMS/BDS degree (mandatory)
- 1+ year in utilization review (denial management)
- Strong communication and analytical skills
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