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Job description
NTT DATA, Inc. in Tampa, Florida seeks a BPO Clinical Review Specialist to perform clinical and medical necessity reviews supporting member and provider appeals.
You will evaluate medical records and criteria to determine necessity and prepare recommendations for Medical Director review, ensuring compliance with NCQA standards and Medicaid guidance. This remote Florida role offers benefits including medical, dental and vision insurance, a 401(k) match, PTO, disability coverage, and a focus on
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Worksite address
tampa, FL, 33646, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.