Jobs near Montebello: 17,123
RS
Relevance Score ranked on: APPEALS
Supervisor, Quality Performance & Grievance and Appeals
Montebello
The Supervisor, Quality, Grievance & Appeals is responsible for the daily oversight, coordination, and performance of all Grievance & Appeals (G&A) functions, while also leading key Quality Management activities that drive regulatory compliance and organizational performance. The Supervisor supports ...
Search Terms: Appeals, Performance, Supervisor, Quality, Healthcare
89.4
0mi
Updated: May 28
Appeals and Grievances - RN, Senior
Long Beach
The Member Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post-service or claim denial. The Appeals and Grievances RN Senior will report to the Appeals and Grievances Manager. In this role you will perform ...
Search Terms: Appeals, RN, Senior, Insurance, Healthcare
83.5
17mi
Updated: May 22
Appeals and Grievances Specialist II
Los Angeles
The 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 Services (CMS), California D...
Search Terms: Appeals, Specialist, Business Services, Healthcare, Experience
82.8
9.2mi
Updated: May 09
Lead Customer Solution Center Appeals and Grievances RN
Los Angeles
The Lead Appeals and Grievances RN is responsible for assisting with the development of a successful and cohesive Appeals and Grievance (A&G) clinical unit. This position is responsible for the quality review of complex and/or escalated clinical A&G cases for all lines of business (LOB). The Lead wil...
Search Terms: Solution, Appeals, RN, Registered Nurse, Lead
81.9
9.2mi
Updated: May 06
Appeals M.D. - Emergency Meds - 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 and...
Search Terms: Appeals, Medical Director, Emergency, Healthcare, Remote
81.7
14mi
Updated: May 16
Appeals M.D. - Emergency Meds - 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 and...
Search Terms: Appeals, Medical Director, Emergency, Healthcare, Remote
81.7
14mi
Updated: May 16
Appeals and Grievances Nurse Specialist RN II
Los Angeles
The Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to members with health care access or benefit coordination issues, ensuring that clinical grievances, complaints and complex issues are investigated and resolved to the member's satisfaction in a man...
Search Terms: RN, Appeals, Specialist, Nurse, Registered Nurse
80.4
9.2mi
Updated: May 08
Appeals Medical Director - General Medicine - 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, Medicine, Medical
80.1
14mi
Updated: May 16
Appeals Medical Director - General Medicine - 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, Medicine, Medical
80.1
14mi
Updated: May 16
Denials Manager RN
San Gabriel
The Denials Case Manager, RN appeals all denials using Inter. Qual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials, maximize accurate and timely reimbursement, and perform reimbursement recovery and retention ...
Search Terms: RN, Manager, Case Manager, Management, Appeals
66
6.8mi
Updated: April 21
- 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.