Teresa Peebles

Nurse Medical Management Ii @Anthem, Inc

Tampa, FL, US

RN Medical Review Clinical Claims & Coding Review Department at Anthem, Inc. Applies clinical knowledge to work with facilities and providers for care coordination. Works with medical directors in interpreting appropriateness of care and accurate appeal payment. Conducts inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing.

Southern Adventist University

Bachelor's degree

University of St. Francis

Master of Science Health Services Administration