- The County of Los Angeles (Los Angeles, CA)
- …staff training is needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review Committee meetings to ... year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator, CCS.**...provided to patients are appropriate and covered by the insurance payer. They are responsible for ensuring that patient… more
- Umpqua Bank (Irvine, CA)
- Credit Review Director Audit and Loan Review Tacoma, Washington Portland, Oregon Lake Oswego, Oregon Irvine, California **Description** **About Us:** At Umpqua, ... to the Chief Audit Executive and the applicable Board committee, the Credit Review Director oversees the Bank's independent loan review activities; provides the… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Utilization review tech essentially works ... and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry, mailing/faxing… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Utilization review tech essentially works ... calls, data entry, mailing/faxing appeals and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals.… more
- Alameda Health System (Oakland, CA)
- …outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity criteria. ... of current trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care) by participating in appropriate… more
- ICW Group (CA)
- …**PURPOSE OF THE JOB** The purpose of the Premium Auditor is to analyze, review , and/or conduct insurance premium audits to determine the actual exposures and ... of our journey as we strive to transform the insurance carrier space. We're proud to be in business...and apply rules and company standards. This position may review audits submitted by field and remote auditors. This… more
- CRC Insurance Services, Inc. (Santa Ana, CA)
- …though eligibility for specific benefits may be determined by the division of TIH Insurance offering the position. TIH offers medical , dental, vision, life ... (Required) **Work Shift:** 1st Shift (United States of America) **Please review the following job description:** Underwrites new and renewal business, approves… more
- Robert Half Legal (Los Angeles, CA)
- …in the United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance . Hired ... to assist with a complex litigation mass tort document review project. Responsibilities: + Conduct document review ...document review project. Responsibilities: + Conduct document review first and second pass via Relativity. + Evaluate… more
- Harris & Associates (Irvine, CA)
- …and expertise of the incoming candidate. In addition to base salary, we also offer: * Medical , dental, vision, and life insurance * ESOP * 401K Match * PTO, 8 ... to help lead, market and expand our Cost Reimbursement Review team. The ideal candidate will have strong project...Paid Leave Programs such as maternity, parentally, and family medical leave Harris & Associates is an Equal Opportunity… more
- Sedgwick (Sacramento, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Estimate Review Specialist **PRIMARY PURPOSE** **:** To review ... or university preferred. **Experience** Five (5) years of experience in insurance adjusting or construction background or equivalent combination of education and… more