I am a self-driven licensed practical nurse with over 2 decades of experience in areas oncology, dialysis, substance abuse and school nursing. As a licensed pharmacy technician for the state of Alabama for the previous 17yrs, with 15 yrs being nationally certified, I believe I could become an asset to your company, with a strong background in medications, medical terminology and customer service.
Investigates and resolves complaints and appeals related to services, claims, or denials.
Ensures compliance with regulations and advocates for clients.
Review clinical information for appeals to determine the need for requested services.
Prepare reviews of cases, gathers and reports about the appeals.