• Grievance & Appeals…

    Robert Half Accountemps (Los Angeles, CA)
    Description A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist . The Grievance & Appeals Specialist , ... and resolving denied claims, complying with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform… more
    Robert Half Accountemps (07/20/25)
    - Related Jobs

  • Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …in a consistent and accurate manner. This position will focus on quality review of non- clinical grievance and appeals cases for all line of business (LOB) ... Customer Solution Center Appeals and Grievances Quality Auditing Specialist ...executing, tracking, and assessing targeted and random audits for non- clinical grievance and appeal case documentation. Ensure… more
    LA Care Health Plan (07/24/25)
    - Related Jobs

  • Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …providers. Duties Provide non- clinical support to the Customer Solution Center Appeals and Grievance Specialists for L. A. Care's Medicare Advantage program. ... responses. (25%) Under the supervision of the Appeals and Grievance Manager, assist with soliciting non- clinical information from Participating Physical… more
    LA Care Health Plan (07/22/25)
    - Related Jobs

  • Associate Medical Director - Genetic Testing

    Elevance Health (Los Angeles, CA)
    …necessity determinations for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures ... ** Clinical Operations Associate Medical Director** **Carelon MBM -...health profession. **Preferred skills, capabilities, and experiences:** + Oncology specialist preferred + Internal medicine specialist preferred… more
    Elevance Health (07/02/25)
    - Related Jobs