- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...policies and procedures. + Documents communications with medical office staff and/or MD provider as required. + Interfaces with… more
- LA Care Health Plan (Los Angeles, CA)
- Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Lead Customer Solution Center Appeals and Grievances RN is responsible for assisting with the development of a… more
- Humana (Sacramento, CA)
- …The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately ... and medical necessity. The Medical Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in accordance… more
- City and County of San Francisco (San Francisco, CA)
- …large Port facilities. Maintenance Managers provide leadership to skilled trades staff , coordinate preventive and corrective maintenance, and support capital and ... Duties of the Maintenance Managers Include: + Plans, schedules, and supervises staff performing maintenance, repair, and construction of Port facilities. + Develops,… more
- University of Southern California (Los Angeles, CA)
- …CPT/HCPCS, DRGs, APCs, and Modifiers-from Medicare, Medi-Cal, MAC, RAC, and commercial insurance companies -when there is refusal or rejection to honor Keck Medicine ... appeal. Performs all 1st and 2nd level coding-related denial appeals . All tasks & duties to be perform in...and maintaining a working relationship with all levels of staff , physicians, and other contacts. Must possess the ability… more
- GuideOne Insurance (Los Angeles, CA)
- …of legal professionals, including Litigation Counsel, outside counsel, and legal support staff . The role requires mastery of drafting and filing motions and ... depositions. + Prepares and drafts pre-trial motions. + Files or defends motion appeals . + Tries lawsuits. + Prepares and drafts post-trial motions. + Manages legal… more
- City and County of San Francisco (San Francisco, CA)
- …work of subordinate law enforcement officers, security officers, and other civilian staff . Assists in the overall administration of an institution security program, ... Exercised: Incumbents in this classification supervise subordinate sworn and non-sworn staff . Responsibilities and Job Duties: 1) Acts emergency operations manager… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- …medical, and legal records. + Prepares, submits, and monitors claims and appeals through appropriate federal, state, and local channels, ensuring compliance with all ... and other agencies in the preparation and presentation of claims and appeals , including cases involving denied benefits. + Monitors, interprets, and applies federal,… more
- City and County of San Francisco (San Francisco, CA)
- …hire multiple management assistants to be part of the City workforce of nearly 40,000 staff and growing. This is a unique opportunity to get direct insights into how ... benefits that include: competitive salaries; medical, dental, and vision insurance ; defined benefit retirement plan; deferred compensation plan; long-term disability… more
- City and County of San Francisco (San Francisco, CA)
- …hire multiple management assistants to be part of the City workforce of nearly 40,000 staff and growing. This is a unique opportunity to get direct insights into how ... benefits that include: competitive salaries; medical, dental, and vision insurance ; defined benefit retirement plan; deferred compensation plan; long-term disability… more