- Cognizant (Sacramento, CA)
- ** Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. ... **Summary:** We are seeking a dedicated Provider Appeals & Grievance Specialist ...directly with CMS Billing and Coding-Medical Insurance Knowledge of Member/ Provider Appeals and Grievances , processes,… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is… more
- LA Care Health Plan (Los Angeles, CA)
- …due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....the retrospective review process for authorizations and Member or Provider Appeals , including, but not limited to… more
- LA Care Health Plan (Los Angeles, CA)
- …Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of… more
- LA Care Health Plan (Los Angeles, CA)
- … Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position ... Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …and resolution of facts and issues in matters affecting disciplinary actions, grievances , appeals , and complaints, refers complex matters to HR Employee ... policy clarification; makes on-site visits to program sites to provide face-to-face HR availability to employees in the work...Relations Specialist or Senior Manager of Employee Relations as required… more
- Cedars-Sinai (Beverly Hills, CA)
- …to match the payor + Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements ... + Coordinates discharge planning and alternative treatment plans with PCP/hospitalist/ specialist as appropriate. + Coordinates the patient's care with other… more