- NTT DATA North America (Ontario, CA)
- …issues, and contract exceptions + Author overpayment/underpayment determinations and coordinate appeals Quality & Compliance + Engage in quality reviews, audits, ... of the role offered. Company benefits may include medical, dental, and vision insurance , flexible spending or health savings account, life, and AD&D insurance ,… more
- Cardinal Health (Sacramento, CA)
- …reviewing the physician's daily schedule and obtaining verification of patients' insurance benefits for their scheduled visits. They will also obtain authorization ... necessary & must be knowledgeable of a variety of Insurance Plans and Policie **Responsibilities** + Submit authorizations for...to not delay patient care. + Complete any pre-service appeals to obtain paying approval based on medical necessity.… more
- Highmark Health (Sacramento, CA)
- …medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and ... + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more
- County of El Dorado (Placerville, CA)
- …high-profile and multi-jurisdictional legal matters, including trials, hearings, and appeals with far-reaching implications. + Lead negotiations, mediation, and ... HSA + Employee Assistance Program (EAP) + Basic Life Insurance + Long Term Disability (LTD) + County sponsored...Retirement + Deferred Compensation (457) Plans + Optional Life Insurance For your Work/Life Balance: + Paid Holidays +… more
- Robert Half Legal (Santa Barbara, CA)
- …Support the development of legal strategies for clients in impactful cases, including appeals and Supreme Court filings. * Contribute to the firm's mission of ... professionals, including medical, vision, dental, and life and disability insurance . Hired contract/temporary professionals are also eligible to enroll in… more
- Cedars-Sinai (Beverly Hills, CA)
- …Hospitals. **Why work here?** Beyond outstanding employee benefits including health and dental insurance , vacation, and a 403(b) we take pride in hiring the best ... Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins… more
- Sharp HealthCare (San Diego, CA)
- …management, and discharge planning, as specified by Sharp, federal, state, and private insurance guidelines. + Core principlesThe RN CM I will make timely referrals ... to Revenue Cycle/HIM regarding RAC decision to appeal, denials, input into appeals , share findings with providers.Review all cases with readmission within 30 days;… more
- Walmart (Sunnyvale, CA)
- …+ Highlighted **production integration** and **customer-facing impact** , which appeals to senior software engineers. **Equal Opportunity Employer** Walmart, Inc. ... coverage. Financial benefits include 401(k), stock purchase and company-paid life insurance . Paid time off benefits include PTO (including sick leave), parental… more
- Evolent (Sacramento, CA)
- …of the request. + Provides clinical rationale for standard and expedited appeals . + Utilizes medical/clinical review guidelines and parameters to assure consistency ... package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on… more
- Elevance Health (Walnut Creek, CA)
- …a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any ... and long term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name a few. Elevance… more