- Adecco US, Inc. (Ontario, CA)
- Adecco is assisting a local client recruiting for Clinical Appeals Representative opportunities in Ontario, CA (90% remote). This is an excellent opportunity ... a winning culture and make an impact in the healthcare industry. If a Clinical Appeals Representative role sounds like something you would be interested in,… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Appeals Representative 4 Investigates and resolves member and practitioner issues. manages ... and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal...a grievance, appeal or further request is warranted. The Appeals Representative 4 + Review documents +… more
- Humana (Sacramento, CA)
- …with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that ... and help us put health first** The Grievances & Appeals Representative 3 manages client denials and...and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal… more
- CVS Health (Sacramento, CA)
- …and responsibilities in accordance with contract. + Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. + ... all with heart, each and every day. **Position Summary** Our Customer Service Representative is the face of Aetna/Mercy Care and impacts members' service experience… more
- City and County of San Francisco (San Francisco, CA)
- …of Aging and Adult Services provide a broad range of clinical /advocacy services to temporary/permanent conservatees and collateral contact with a multidisciplinary ... FUNCTIONS According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job class and are not… more
- City and County of San Francisco (San Francisco, CA)
- …DUTIES According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job class and are not ... Master's Degrees in counseling include Marriage and Family Therapy, Clinical Counseling, Mental Health Counseling, Addiction Counseling and Counseling Psychology… more
- City and County of San Francisco (San Francisco, CA)
- …Functions According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job class and are not ... Master's Degrees in counseling include Marriage and Family Therapy, Clinical Counseling, Mental Health Counseling, Addiction Counseling and Counseling Psychology… more
- Highmark Health (Sacramento, CA)
- …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document all… more
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