- United Therapeutics (CA)
- …criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate physician office staff on the use of ... HCPs on client specific patient service programs (ie copay, nurse education, patient assistance, etc.) + Ability to manage...as Zoom, Webex, and/or Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare… more
- Alameda Health System (Oakland, CA)
- …Their responsibilities span from managing admissions to ensuring clean claims , identifying trends, and optimizing resource utilization. This role supports ... evaluate the utilization of healthcare services, including appropriateness, efficiency, and medical necessity of treatments and procedures. + Analyze data and… more
- Sutter Health (Modesto, CA)
- …management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers ... experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and… more