- Sharp HealthCare (San Diego, CA)
- …Will Do** Responsible for the investigation, documentation and resolution of member appeals and grievances in compliance with State law, rules, and guidelines; ... Chief Medical Officer (CMO) who is responsible for all decisions regarding clinical appeals and grievances and the Chief Operations Officer (COO) who is responsible… more
- Sharp HealthCare (San Diego, CA)
- …Do** Responsible for the investigation, documentation and resolution of Commercial member appeals and grievances in compliance with State law, rules, and guidelines; ... Chief Medical Officer (CMO) who is responsible for all decisions regarding clinical appeals and grievances and the Chief Operations Officer (COO) who is responsible… more
- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- CVS Health (Sacramento, CA)
- …Appeal Coordinator ** coordinates reviews and evaluations for complaints and appeals received by the organization. This includes denied claims, coverage issues, ... and independently coaches others on matters regarding complaints and appeals . **In this role, you will:** + Handle quality...role, you will:** + Handle quality checks for the appeals team, in order to ensure overall accuracy. +… more
- Sacramento County (Sacramento, CA)
- Treatment Center Program Coordinator Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1180508) Apply Treatment Center Program Coordinator ... Service Commission, 700 H Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days after notice of the… more
- Elevance Health (Fresno, CA)
- …to client needs, and direct, hands-on engagement. The **LTSS Service Coordinator ** is responsible for conducting service coordination functions for a defined ... + Assists and participates in appeal or fair hearings, member grievances, appeals , and state audits. **Minimum Requirements:** + Requires BA/BS degree and a… more
- Cardinal Health (Sacramento, CA)
- …industry including Commercial and Government plans, Prior Authorizations, and Appeals + Experience with Microsoft Office products including Word, PowerPoint, ... Teams, Outlook, and Excel + Excellent observation skills to easily identify trends and problems while providing solutions + Superior written & verbal communication skills + Required to effectively present information in a one-on-one and small group situations… more
- Sutter Health (Santa Clara, CA)
- …as necessary to gather additional information and convey approvals, denials or appeals . + Provides excellent customer service by listening to provider, staff and ... patient concerns and assisting them in resolving issues in a courteous manner while documenting appropriately. + Cross-trains others to assure consistent coverage; provide back up support as needed. **EDUCATION:** HS Diploma or GED **TYPICAL EXPERIENCE:** 1… more
- Affordable Care (Redding, CA)
- …handling dental office finances, full insurance billing process (including claims submission, appeals , and denial management) and being able to multi-task. You must ... be able to work in a high volume, fast paced office while maintaining a positive and friendly attitude. **Apply today by clicking "Apply Now"!** **About Affordable Care** Founded in 1975, today Affordable Care, LLC is America's largest dental support… more
- The County of Los Angeles (Los Angeles, CA)
- …update parcel information, and/or enroll property tax assessments. + Prepares assessment appeals cases and testifies as an expert witness at Assessment Appeals ... the assessment process, for Part I contact the Testing Accommodations Coordinator ###@hr.lacounty.gov, for Part II ###@assessor.lacounty.gov. We require a completed… more