- Cognizant (Sacramento, CA)
- …cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and concurrent reviews . ... help you stand out** . Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is a plus. We're excited to meet people… more
- Stanford Health Care (Palo Alto, CA)
- …analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding ... is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist ...Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist ...manner. This position will focus on quality review of non- clinical grievance and appeals cases for all… more
- City and County of San Francisco (San Francisco, CA)
- …assists with designing and implementing plans for meeting such needs. The Clinical Nurse Specialist performs other related duties as assigned/required. Minimum ... by the California Board of Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Robert Half Accountemps (Santa Barbara, CA)
- Description We are looking for a meticulous Medical Billing Specialist to join our team in Santa Barbara, California. This long-term contract position offers an ... excel in communication and collaboration, supporting both patients and clinical staff in navigating complex billing and authorization procedures. Responsibilities:… more
- Insight Global (Pleasanton, CA)
- Job Description Insight Global is seeking a Medicare Billing Specialist to join their clients team. The Medicare Billing Specialist is responsible for the ... accounts and resolve payment discrepancies. * Identify underpayments and coordinate appeals or resubmissions. * Maintain current knowledge of CMS and Medicare… more
- Robert Half Accountemps (Duarte, CA)
- Description We are looking for an experienced Medical Biller/Collections Specialist to join our team in Duarte, California. The Medical Biller/Collections ... Specialist will play a vital role in managing the...measures to reduce future denials. * Draft and submit appeals for claim denials to secure appropriate reimbursements. *… more
- Emanate Health (Covina, CA)
- …in the United States, and the #19 ranked company in the country. The Denial Specialist is responsible for denial and AR management as defined by Denial Manager. The ... Denial Specialist will possess and apply thorough knowledge of collections...patient account that is involved in the audit and appeals process to accurately complete accounts receivable reconciliation. **Minimum… more
- City and County of San Francisco (San Francisco, CA)
- …limited to experience: + Working with vulnerable patient populations + Supervising clinical and administrative professionals + Improving clinical quality + ... 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
- LA Care Health Plan (Los Angeles, CA)
- …dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters to ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID:… more