- LA Care Health Plan (Los Angeles, CA)
- Manager, Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage… more
- Cardinal Health (Sacramento, CA)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- UCLA Health (Los Angeles, CA)
- …medical terminology, and confidentiality compliance + Proven ability to resolve complex claims , process adjustments, and manage appeals effectively + Proficiency ... Description UCLA Health is seeking a Senior Cross-Functional Collections Representative to support Patient Business Services by managing a diverse portfolio of… more
- Robert Half Accountemps (Palo Alto, CA)
- Description We are seeking a Patient Account Representative to join a fast-paced and collaborative Patient Financial Services (PFS) team. The Patient Account ... Representative is responsible for accurate and timely billing, collections,...or phone communication. + Investigate and resolve underpayments; file appeals when necessary. + Review and resolve claim denials… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …claim submission. This position is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to validate and ... incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic...accurately complete the claims identified with potential new payor plan coverage added… more
- CVS Health (Sacramento, CA)
- …heart, each and every day. **Position Summary:** Health Concierge -Customer Service Representative is the face of Aetna to provide targeted, personalized service ... to assist customers in understanding components of the Aetna products including claims , accumulators, usage and balances, and cost sharing. + Answers questions and… more
- City and County of San Francisco (San Francisco, CA)
- …& DUTIES According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job class and are not ... perform the following duties: QUALITY CONTROL, INVESTIGATIONS, OVERPAYMENTS, AND/OR APPEALS SPECIALIST Under general supervision, the Quality Control, Investigations,… more
- Wounded Warrior Project (San Diego, CA)
- …military service. The NSO guides and manages the preparation and processing of all claims and subsequent appeals through the Department of Defense (DoD) and ... the DoD and DVA. + Prepare briefs for pending appeals located at the local VA Regional Office level....laws and regulations when researching, filing, and closing benefits claims . + Working knowledge of all VBA electronic systems,… more
- Highmark Health (Sacramento, CA)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... priority Congressional / Department of Defense), and appeals . Ensures that all processes are compliant with requirements and performance standards are consistently… more
- Clay Lacy Aviation (Van Nuys, CA)
- …escalation point for sensitive payroll issues, wage disputes, and labor claims , providing strategic counsel and documentation to mitigate legal and financial ... Serve as a key advisor in resolving complex employee benefit issues, appeals , and escalations with empathy, professionalism, and consistency. + Maintain full… more