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Talent Software Services, Inc

UM Genetic Counselor- Medical Reviewer

USIndividual contributorvia adzuna
genetic counselingmedical reviewutilization reviewprior authorization

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Day to Day Responsibilities In this role, the Genetic Counselor will do the following: Perform prospective and retrospective utilization reviews and first level determination approvals for members using evidenced based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of business such as Commercial or Medicare. Conduct clinical review of prior authorization requests for medical necessity, coding accuracy, medical policy compliance,…

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