- Executive Office for US Attorneys and the Office of the US… (Sacramento, CA)
- …in both Sacramento and Fresno, and will be supported by a staff of paralegals, investigators, auditors and other professionals. Responsibilities will increase and ... cases with substantial responsibility for all aspects of discovery, trial, and appeals . Applicants must demonstrate a quick analytical ability and the facility to… more
- Stantec (Sacramento, CA)
- …culture, and connecting across borders with some of the world's top talent appeals to you, join us. The successful candidate will work on challenging and ... and provide technical review of work products. + Lead and mentor less experienced staff . + Manage projects and tasks with the assistance of 1 to 10 engineers.… more
- Evolent (Sacramento, CA)
- …care aligned with clinical guidelines. + Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making. + Act as a ... practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls)...+ Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely… more
- Cedars-Sinai (Los Angeles, CA)
- …guidelines, provides Commercial and Government billing and collections support to Insurance Follow up and Accounts Receivable, performing duties which may include ... and provide back-up coverage. In this role you will effectively bill, submit appeals and collect monies relative to physician reimbursements. You will be in charge… more
- Highmark Health (Sacramento, CA)
- …could be a result of internal/external audits, member/provider phone calls, other insurance information received, appeals , and system changes, etc.; provides ... ensuring timeliness and accuracy of all work given by support staff /management. Maintains accurate records, including timekeeping records and attends all required… more
- Cedars-Sinai (Los Angeles, CA)
- …and resolve complex cases and problem accounts with minimal assistance. Submits appeals and collect monies relative to physician reimbursement. Services as a ... required. College level courses in Finance, Business or Health Insurance preferred. + Minimum of 4 years of hospital...take pride in hiring the best employees. Our accomplished staff reflects the culturally and ethnically diverse community we… more
- Elevance Health (Costa Mesa, CA)
- …Associate Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. ... for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of medical… 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 ... assisting with care coordination, training, and quality improvement activities; provides staff education regarding Advance Directives and POLST when requested. +… more
- Elevance Health (Los Angeles, CA)
- …May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. ... 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… more
- Stantec (Sacramento, CA)
- …on your talents through knowledge-sharing with some of the world's top talent appeals to you, join us! **Your Responsibilities** + Working with a multi-discipline ... written communication skills, report preparation, and the ability to work with engineering staff at all levels. + Travel time should be anticipated (minimum of… more