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Remote RN Clinical Appeals Reviewer; Florida)
Remote / Online - Candidates ideally in
Tampa, Hillsborough County, Florida, 33646, USA
Listed on 2026-08-31
Tampa, Hillsborough County, Florida, 33646, USA
Listing for:
NTT DATA, Inc.
Remote/Work from Home
position Listed on 2026-08-31
Job specializations:
-
Nursing
RN Nurse, Clinical Nurse Specialist, Healthcare Nursing
Job Description & How to Apply Below
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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