- Centene Corporation (Sacramento, CA)
- …optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and ... medical necessity appeals . + Participates in provider network development and new...work in the areas of Health Administration, Health Financing, Insurance , and/or Personnel Management is advantageous. Experience treating or… more
- SpaceX (Hawthorne, CA)
- …Property Tax Manager responsible for managing property tax compliance, audits, and appeals processes nationwide, and leading all aspects of property tax strategy and ... with managing relationships with external consultants + Experience with appeals process in Texas, and other states + Familiarity...to a 401(k) retirement plan, short and long-term disability insurance , life insurance , paid parental leave, and… more
- Emanate Health (Covina, CA)
- …for Qualified Candidates. Must have experience in hospital collections and insurance collections.** **J** **ob Summary** Performs account follow up from third-party ... payers including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International… more
- Stanford Health Care (Palo Alto, CA)
- …Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR ... - Payer clerical and technical denial review and request processing including basic appeals - Payment posting and batch reconciliation - Credit balance review and… more
- City and County of San Francisco (San Francisco, CA)
- …and accounts involving lawsuits and estates + Communicates with patients, physicians, insurance representatives and other for the purpose of collecting payments. The ... service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance , third-party payors, and individual payors in a hospital, healthcare… more
- County of El Dorado (Placerville, CA)
- …and file legal briefs and memoranda relating to prosecution activities and appeals , conduct original and supplemental investigation of cases, prepare for and conduct ... trials, post-trial and sentencing hearings, and appeals . To view the full job description, please click...HSA + Employee Assistance Program (EAP) + Basic Life Insurance + Long Term Disability (LTD) + County sponsored… more
- Alameda Health System (Oakland, CA)
- …communication and collaboration with internal departments, external agencies, and insurance providers to facilitate the utilization review process. + Participate ... of quality improvement initiatives. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals .… more
- Insight Global (Pleasanton, CA)
- …accounts and resolve payment discrepancies. * Identify underpayments and coordinate appeals or resubmissions. * Maintain current knowledge of CMS and Medicare ... or audits. * Investigate and resolve denied or rejected claims. * Prepare appeals with supporting documentation as needed. * Track denial trends and recommend… more
- Amergis (French Camp, CA)
- …Acute Case Management experience ? Key Responsibilities: + Discharge Planning + Appeals & Denials + Utilization Review + InterQual assessments + Collaborating with ... Case Management experience + Current Discharge Planning experience + Denials & Appeals experience + Utilization Review experience + InterQual experience + Knowledge… more
- City and County of San Francisco (San Francisco, CA)
- …+ Candidates must be insurable under the department's automobile liability insurance policy. After employment, employees must maintain insurability and valid driver ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...be appealed under the Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more