- Elevance Health (Costa Mesa, CA)
- …an impact:** + Receives pre-authorization requests from front-line intake and nurse reviewers. + Conducts initial medical necessity clinical screenings. + Determines ... pre-authorization requests for services. + Conducts review of grievance and appeals requests to provide to Medical Directors. **Minimum Requirements:** + Requires… more
- Sutter Health (Berkeley, CA)
- …ABSMC-Alta Bates Herrick Campus **Position Overview:** Responsible for insurance verification and eligibility, assessment of patient financial requirements, ... counseling patients on insurance benefits and co-payments, and obtaining preauthorization for all...data into comment box. Communicates with supervisor or charge nurse , physicians, practice staff when there are issues with… more
- Alameda Health System (San Leandro, CA)
- …other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed. + Encourages patients to develop realistic plans. Makes ... regarding Advance Directives and POLST when requested. + Understands insurance , governmental, and accrediting agency standards to determine criteria concerning… more
- Sharp HealthCare (San Diego, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) ... equivalent experience in the healthcare setting. + California Registered Nurse (RN) - CA Board of Registered Nursing **Preferred...planning, as specified by Sharp, federal, state, and private insurance guidelines. + Core principlesThe RN CM I will… more
- Sacramento County (Sacramento, CA)
- …available to you. These benefits currently include: health, dental and life insurance ; flexible spending account options for dependent care and unreimbursed dental ... RETIREMENT: Social Security and Sacramento County Employees' Retirement System coverage. HEALTH INSURANCE : The County offers a variety of health plan design options… more
- Centene Corporation (Sacramento, CA)
- …available services. + Researches and prepares conflict resolution documentation to support Appeals and Grievances. + Prepares and submits monthly and quarterly COC ... Medical Assistant Certification, or current, valid and unrestricted Licensed Vocational Nurse (LVN) license or current, valid and unrestricted Pharmacy Technician… more