Jobs near Cypress: 14,928
RS
Relevance Score ranked on: APPEALS
Senior Pharm PA/Appeals Technician
Cypress
Become knowledgeable with our process to best support our members Expected to meet departments production, quality, and success rate standards Work independently and as a team player to achieve individual and departmental goals Make outbound phones to collect clinical information for Medicare Part D ...
Search Terms: Technician, Pharmacy Technician, Appeals, Senior, Health
86.7
0mi
Updated: May 08
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
86.2
0mi
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
86.2
0mi
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
85.9
0mi
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
85.9
0mi
Updated: April 23
Nurse Appeals (RN) CA
CERRITOS, 12900 PARK PLAZA DR
Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical information for medical director, consultants and other external review....
Search Terms: Appeals, Nurse, Medical Director, Skills, Healthcare
83.3
3.6mi
Updated: April 30
Nurse Appeals (RN) CA
CERRITOS, 12900 PARK PLAZA DR
Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical information for medical director, consultants and other external review....
Search Terms: Appeals, Nurse, Medical Director, Skills, Healthcare
83.3
3.6mi
Updated: April 30
Nurse Appeals (RN) CA
CERRITOS, 12900 PARK PLAZA DR
Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical information for medical director, consultants and other external review....
Search Terms: Appeals, Nurse, Medical Director, Skills, Healthcare
83.3
3.6mi
Updated: April 30
Nurse Appeals (RN) CA
COSTA MESA, 3080 BRISTOL ST, STE 200
Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical information for medical director, consultants and other external review....
Search Terms: Appeals, Nurse, Medical Director, Skills, Healthcare
81.1
12mi
Updated: April 30
Nurse Appeals (RN) CA
COSTA MESA, 3080 BRISTOL ST, STE 200
Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical information for medical director, consultants and other external review....
Search Terms: Appeals, Nurse, Medical Director, Skills, Healthcare
81.1
12mi
Updated: April 30
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