- Cardinal Health (Sacramento, CA)
- …in 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...changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Movn Health (CA)
- …to all payers within 24 hours of service + Review and process claim denials and rejections, executing timely appeals and follow-up strategies + Aggressively ... is a self-starter with a proven track record in A/R recovery, claim appeals , and payer follow-ups. Experience in startup environments and cardiovascular care is… more
- UCLA Health (Los Angeles, CA)
- …guidelines and maintain quality control for paper claims. + Handle tracers, denials , and related correspondence, including initiating appeals and drafting appeal ... claims. This role requires expertise in billing guidelines, customer service, and appeals processes, as well as strong interpersonal and technical skills. In this… more
- Prime Healthcare (Ontario, CA)
- …Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. Utilization review ... tech is responsible for coordinating phone calls, data entry, mailing/faxing appeals and tracking data from various insurance providers and health plans regarding… more
- Prime Healthcare (Ontario, CA)
- …Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. This position will ... team while being responsible for coordinating phone calls, data entry, mailing/faxing appeals and tracking data from various insurance providers and health plans… more
- Robert Half Office Team (Palm Springs, CA)
- …Facilitate appeals and resolution of disputes related to provider denials or credentialing errors as per California laws and managed care regulations. ... and timelines and respond to inquiries promptly. Renewals and Appeals : Manage provider contract and credentialing renewals within California-specific timeframes.… more
- Cardinal Health (Fresno, CA)
- …to check claim status, request reprocessing or 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… more
- Emanate Health (Covina, CA)
- …and all other non-governmental third-party payers. Duties include collections, appeals , billing, adjustments, EOB review, correspondence and managing all types ... of denials . Works on special complex high priority projects as...setting, with strong emphasis on managed care contract and appeals /underpayment collection activities. Excellent customer service skills. Knowledge of… more
- Robert Half Office Team (Palm Springs, CA)
- …and regulatory agencies to facilitate clear communication. * Handle renewals and appeals related to credentialing errors or provider denials in accordance ... with state laws. * Identify and implement process improvements to streamline credentialing workflows and enhance efficiency. * Stay informed about changes in healthcare regulations and adjust processes accordingly. Requirements * Associate's or Bachelor's… more