- Cardinal Health (Fresno, CA)
- …escalate issues. + Analyze denials and underpayments to determine appropriate action ( appeals , corrections, resubmissions). + Track and follow up on all submitted ... appeals until resolution. + Analyze explanation of benefits (EOBs) and remittance advice to determine the reason for denial or reduced payment. + Document all… more
- J&J Family of Companies (Fresno, CA)
- …assigned. + Educate HCPs on product coverage, prior authorizations and appeals , reimbursement processes, claims submissions, procedures, and coding requirements of ... care experience (revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes) + Ability to establish relationships, collaborate, and influence… more
- Robert Half Accountemps (Los Angeles, CA)
- …on unpaid claims to improve collections. + Research and resolve denials and appeals to maximize reimbursement. + Maintain strict adherence to HIPAA regulations and ... + Hands-on experience with medical insurance collections, denials management, and appeals processes. + Working knowledge of medical coding systems (CPT, ICD-10,… more
- Highmark Health (Sacramento, CA)
- …correspondence inquiries (routine, priority Congressional / Department of Defense), and appeals . Ensures that all processes are compliant with requirements and ... Provides direction for priority Congressional and Department of Defense inquiries and appeals . + Performs administration tasks such as leave approvals and functions… more
- Stanford University (Stanford, CA)
- …for enhancing global benefit programs. + Reviews initial and second-level appeals relating to global benefit plan eligibility and/or contributions and makes ... + Ability to analyze complex situations (ie, benefit issues, appeals , administrative issues), identify workable solutions/alternatives, and make appropriate… more
- Cardinal Health (Sacramento, CA)
- …+ Must follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be ... documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Cell/Gene therapy and/or Oncology experience, preferred +… more
- Centene Corporation (Sacramento, CA)
- …optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and ... medical necessity appeals . + Participates in provider network development and new market expansion as appropriate. + Assists in the development and implementation of… more
- City and County of San Francisco (San Francisco, CA)
- …examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service Commission. ... The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S… more
- City and County of San Francisco (San Francisco, CA)
- …examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service Commission. ... The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S… more
- City and County of San Francisco (San Francisco, CA)
- …examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service Commission. ... The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S… more