Jobs near Cypress: 13,376
RS
Relevance Score ranked on: APPEALS
Clinical Appeals RN - National Remote
Cypress
Review provider post-service appeals for Medicare and Retirement Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines Discuss cases with medical directors when applicable Ability to communicate and collaborate with other teams in order to g...
Search Terms: RN, Appeals, Clinical, Medical Director, Remote
87.7
0mi
Updated: November 26
Appeals and Grievances Analyst
Los Angeles
As the Appeals and Grievances (A&G) Analyst, you will be responsible for assisting with all operational aspects of appeals and grievances, in accordance with state and federal regulations. You will: Manage various weekly/monthly deadlines effectively due to the time constraints imposed by CMS on Medi...
Search Terms: Appeals, Analyst, Operations, Administrative, Healthcare
83
16mi
Updated: November 14
Senior Appeals & Grievances Analyst
Los Angeles
As the Senior Appeals and Grievances Analyst, you will be responsible for: Assisting with all operational aspects of appeals and grievances, in accordance with state and federal regulations. Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that members and prov...
Search Terms: Appeals, Analyst, Senior, Technology, Healthcare
83
16mi
Updated: November 14
Appeals and Grievances Analyst
Los Angeles
As the Appeals and Grievances (A&G) Analyst, you will be responsible for assisting with all operational aspects of appeals and grievances, in accordance with state and federal regulations. You will:Manage various weekly/monthly deadlines effectively due to the time constraints imposed by CMS on Medic...
Search Terms: Appeals, Analyst, Operations, Administrative, Healthcare
83
16mi
Updated: November 14
Senior Appeals & Grievances Analyst
Los Angeles
As the Senior Appeals and Grievances Analyst, you will be responsible for:Assisting with all operational aspects of appeals and grievances, in accordance with state and federal regulations. Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that members and provi...
Search Terms: Appeals, Analyst, Senior, Technology, Healthcare
83
16mi
Updated: November 14
Senior Appeals & Grievances Analyst
Los Angeles
As the Senior Appeals and Grievances Analyst, you will be responsible for:Assisting with all operational aspects of appeals and grievances, in accordance with state and federal regulations. Assisting the unit Supervisor in overseeing the appeals and grievances process, ensuring that members and provi...
Search Terms: Appeals, Analyst, Senior, Technology, Healthcare
83
16mi
Updated: November 14
Customer Solution Center Appeals and Grievances Nurse Specialist LVN II
Los Angeles
The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall coordination of the Appeals & Grievance (A&G) program for L. A. Care Health Plan members under the direct supervision and management of the A&G Nurse Specialist, RN and/or Medical Dire...
Search Terms: Solution, Appeals, LVN, Specialist, Nurse
81
21mi
Updated: November 04
Customer Solution Center Appeals and Grievances Nurse Specialist RN II
Los Angeles
The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to member's with health care access or benefit coordination issues, ensuring that clinical grievances, complaints and complex issues are investigated and resolved to the memb...
Search Terms: Solution, RN, Appeals, Specialist, Nurse
79.9
21mi
Updated: November 19
Appeals & Grievances Nurse
Los Angeles
As the Appeals & Grievances Nurse, you will play a key role in managing and resolving New Century Health Plan member appeals and grievances. You will: Ensuring timely, accurate, and thorough review of member and provider complaints, working closely with clinical and administrative teams. Assessing ca...
Search Terms: Appeals, Nurse, Healthcare
79.8
16mi
Updated: October 31
Appeals & Grievances Specialist
Los Angeles
As the Appeal & Grievance Specialist, you will be responsible for:Managing the intake and resolution of member and provider appeals and grievances in compliance with CMS (Centers for Medicare & Medicaid Services) regulations for Medicare Advantage plans. Ensuring that all cases are processed within m...
Search Terms: Appeals, Specialist, Healthcare, Medical Director
79
16mi
Updated: October 31
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