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  • HMSA
  • Kapolei, HI United States
  • 05/25/2017
  • Healthcare
Under minimal supervision, conducts detailed analysis and review of precertification requests, post-service and post-payment claims, concurrent review and facility monitoring by applying clinical expertise against HMSA medical and reimbursement policy criteria, plan benefits, and nationally-accepted...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 05/25/2017
  • Healthcare
A Nurse Reviewer performs a detailed analysis and review of the medical records applying clinical expertise, evidence based clinical guidelines, HMSA policies and knowledge of standard practice to determine the appropriateness of care, diagnoses and procedures used to facilitate the adjudication of ...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 05/25/2017
  • Healthcare
Under minimal supervision, conducts detailed analysis and review of inpatient hospital stays and suspended claims, by applying clinical expertise against HMSA medical and reimbursement policies, plan benefits and nationally-accepted clinical guidelines to determine appropriateness of care for all HM...  More Details
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