- CVS Health (Sacramento, CA)
- …and escalates issues as appropriate through the system for grievances and appeals . + Initiates out-reach/welcome calls to ensure constituents expectations are met or ... exceeded. + Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member… more
- Transdev (Oakland, CA)
- …establishing reasons for denial of ADA eligibility appropriate for presentation during an Appeals Process. As a Travel Trainer, you will not only help drive ... operational excellence but also contribute to meaningful advancements in transportation that impact our community. We are seeking customer service-oriented professionals who are advocates for public transportation services. Transdev is proud to offer: +… more
- Ventura County (Ventura, CA)
- …a broad variety of human resources matters, including examination appeals , administrative investigations, validation reports, and classification and compensation ... studies. + Designs, administers, and evaluates training and development programs. + May supervise staff engaged in a broad variety of human resources functions. + Performs other duties as assigned. Typical Qualifications These are entrance requirements to the… more
- Stanford University (Stanford, CA)
- …content review, parking data collection, and the review of citation appeals . Evaluates the campus-related achievements of subordinate staff, establishing clear team ... goals and objectives under the guidance of the Associate Director. Manages the accountability and stewardship of human, financial, and physical resources in alignment with departmental and university-wide goals. Ensures direct staff adhere to established… more
- City and County of San Francisco (San Francisco, CA)
- …The terms of this announcement may be appealed under Civil Service 211.6. Such appeals must be submitted in writing to the Department of Human Resources, 1 S ... Van Ness Avenue, 4th Floor, San Francisco, CA 94103-5413 by close of business on the 7th business day following the issuance date of this announcement. Information concerning other Civil Service Commission Rules involving announcements, applications and exam… more
- Amergis (French Camp, CA)
- …x 2 years Denials nurse: We need someone that is current with Denials, Appeals and utilization review . If a candidate had experience with PERFORMANT or CDCR ... denials that would be amazing, but it is not likely we will find that. Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: + Competitive pay & weekly paychecks +… more
- Ventura County (Ventura, CA)
- …with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders based on denials; + Assists in ... organizing, coordinating, and directing of coding activities of the Health Information Management Department at VCMC; + Reviews and evaluates policies and procedures for the Medical Records Department in relation to the overall hospital goals; in coordination… more
- Cardinal Health (Sacramento, CA)
- …the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes ... denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with all information received from secondary insurance companies. +… more
- Sacramento Municipal Utility District (Sacramento, CA)
- …Relations work, including disciplinary documents, reports, responding to grievances or appeals **Physical Requirements** Applicants must be able to perform the ... essential job functions with or without a reasonable accommodation. **Our Commitment to Diversity & Inclusion** SMUD celebrates diversity, and inspires an inclusive culture based on trust and respect to create belonging and connection among our employees,… more
- Cedars-Sinai (Los Angeles, CA)
- …and provide back-up coverage. In this role you will effectively bill, submit appeals and collect monies relative to physician reimbursements. You will be in charge ... of monitoring and processing accounts that are both straightforward or may need further research in order to bring resolution. You will work with minimal direction from management to ensure the integrity of the work performed. We work in a team environment to… more