- NTT DATA North America (Ontario, CA)
- …issues, and contract exceptions + Author overpayment/underpayment determinations and coordinate appeals 1. Quality & Compliance + Engage in quality reviews, audits, ... experience **Preferences** + Excellent analytical and communication skills + Experience training staff or acting as a mentor + Familiarity with system testing and… more
- NTT DATA North America (Ontario, CA)
- …issues, and contract exceptions + Author overpayment/underpayment determinations and coordinate appeals Quality & Compliance + Engage in quality reviews, audits, ... regulatory guidelines + Excellent analytical and communication skills + Experience training staff or acting as a mentor + Familiarity with system testing and… 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 ... employees. Our accomplished staff reflects the culturally and ethnically diverse community we...and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy.… more
- Elevance Health (Walnut Creek, 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
- Ventura County (Ventura, CA)
- …contribution towards a flexible benefits program (including medical, dental, and vision insurance options). + Flexible Spending Accounts - Choice of participation in ... help - both inside and outside the courtroom. Our staff includes experts in litigation and trial advocacy, as...include Misdemeanor and Felony trial teams, Immigration, Writs and Appeals , Juvenile, and Mental Health, plus several specialty courts,… more
- Elevance Health (Costa Mesa, CA)
- …Operations 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 company… more
- Executive Office for US Attorneys and the Office of the US… (San Francisco, CA)
- …settlements, preparing cases for trial, trying cases, and briefing and arguing appeals . Applications are considered on a rolling basis, so kindly submit your ... likely have difficulty being approved for appointments by the Department Security Staff . The two-year period is cumulative, not necessarily consecutive. Federal or… more
- Executive Office for US Attorneys and the Office of the US… (San Francisco, CA)
- …legal issues, and represent the United States in hearings, trials, and appeals . Day-to-day responsibilities include working with law enforcement agencies and others ... likely have difficulty being approved for appointments by the Department Security Staff . The two-year period is cumulative, not necessarily consecutive. Federal or… more
- Ventura County (Ventura, CA)
- …accuracy rate, compliance rate with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to ... and collaborate with Clinical Documentation Specialist team; + Provides coding guidance to staff on the most difficult coding cases; + Ensures VCMC coding practices… 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