- Cognizant (Sacramento, CA)
- …cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and concurrent reviews . ... have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical ...stand out** . Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is… more
- City and County of San Francisco (San Francisco, CA)
- …and assists with designing and implementing plans for meeting such needs. The Clinical Nurse Specialist performs other related duties as assigned/required. ... by the California Board of Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Stanford Health Care (Palo Alto, CA)
- …analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding ... is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist ...Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and… more
- Cedars-Sinai (Beverly Hills, CA)
- …care. Use Milliman and Interqual guidelines as necessary. + Collaborates with clinical teams and practices to ensure synchronization of sub-areas' operations to ... Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins… more