Jobs near Los Angeles: 15,780
RS
Relevance Score ranked on: APPEALS
Customer Solution Center Appeals and Grievances Specialist II
Los Angeles
The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment. This position will provide resolution of complaints in compliance with Centers for Medicare and Medicaid Ser...
Search Terms: Solution, Appeals, Specialist, Customer, Technology
88.6
0mi
Updated: April 16
Manager, Customer Solution Center Appeals and Grievances
Los Angeles
The Manager, Customer Solution Center Appeals and Grievances is responsible for the centralized intake, logging and triage process for all member appeals and grievances. The Manager oversees the resolution of member appeals and grievances for all product lines (Medi-Cal, Medi-Cal Direct, Medicare, PA...
Search Terms: Solution, Manager, Appeals, Network Operations, Customer
86.9
0mi
Updated: March 14
Supervisor, Appeals and Grievances Clinical Operations RN
Los Angeles
The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the day-to-day clinical operations of the A&G department, and monitoring the A&G RN staff responsibilities and activities. This includes, but is not limited to, ensuring proper staffing and coverage; mo...
Search Terms: Operations, Clinical, RN, Supervisor, Appeals
85.9
0mi
Updated: March 28
Customer Solution Center Appeals and Grievances Quality Auditing Specialist II
Los Angeles
The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is responsible for assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and cohesive unit with a high level of productivity and focus on implementing, executing, tracking...
Search Terms: Solution, Audit, Appeals, Specialist, Quality
85.6
0mi
Updated: March 21
Appeals and Grievances Medical Director - Otolaryngology (ENT) Specialty Required - Remote
Cypress
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical c...
Search Terms: Medical Director, Director, Appeals, Medical, Healthcare
81.9
21mi
Updated: April 26
Appeals and Grievances Medical Director - Otolaryngology (ENT) Specialty Required - Remote
Cypress
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical c...
Search Terms: Medical Director, Director, Appeals, Medical, Healthcare
81.9
21mi
Updated: April 26
Grievance and Appeals Coordinator (CA residents)
Los Angeles
Speaki[ "\n\tspeaking with healthcare providers and members\n\tutilizing different material and navigating through systems\n\tcommunicating with internal and external parties\n\tformulating responses in writing to members\n\n" ][ "Experience. Experienced 1 year. Education. High School" ]
Search Terms: Coordinator, Appeals, Administrative, Staffing
81.7
5.7mi
Updated: April 26
Appeals and Grievances Medical Director - PM&R Physician - Remote
Cypress
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical c...
Search Terms: Medical Director, Director, Appeals, Medical, Physician
80.7
21mi
Updated: April 23
Appeals and Grievances Medical Director - PM&R Physician - Remote
Cypress
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical c...
Search Terms: Medical Director, Director, Appeals, Medical, Physician
80.7
21mi
Updated: April 23
Appeals and Grievances Medical Director - Radiology Specialty Required - Remote
Cypress
The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. Performance accountabilities include: Perform individual case review for appeals and grievances for various health plan an...
Search Terms: Medical Director, Director, Appeals, Radiology, Medical
80.3
21mi
Updated: April 05
- 1
- 2
- 3
- 4
- >
Job Abstracts is an independent Job Search Engine. Job Abstracts is not an agent or representative and is not endorsed, sponsored or affiliated with any employer. Job Abstracts uses proprietary technology to keep the availability and accuracy of its job listings and their details. All trademarks, service marks, logos, domain names, and job descriptions are the property of their respective holder. Job Abstracts does not have its members apply for a job on the jobabstracts.com website. Additionally, Job Abstracts may provide a list of third-party job listings that may not be affiliated with any employer. Please make sure you understand and agree to the website's Terms & Conditions and Privacy Policies you are applying on as they may differ from ours and are not in our control.