Jobs near Costa Mesa: 8,532
RS
Relevance Score ranked on: APPEALS
Manager II Grievance/Appeals (RN)
COSTA MESA, 3080 BRISTOL ST, STE 200
Maintains and coordinates staff activities to achieve departmental and corporate goals to improve service to customers/providers and assures regulatory compliance. - Analyzes and develops strategies by achieving performance thresholds within budgetary guidelines. - Addresses both internal/external cu...
Search Terms: Manager, Appeals, Administrative, Healthcare, Benefits
87.7
0mi
Updated: May 19
Nurse Appeals-CA
COSTA MESA, 3080 BRISTOL ST, STE 200
Responsible for investigating and processing and medical necessity appeals requests from members and providers. Primary duties may include, but are not limited to:Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective med...
Search Terms: Appeals, Nurse, Medical Director, Skills, Healthcare
86.3
0mi
Updated: April 09
Nurse Appeals 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
85.7
0mi
Updated: May 01
Nurse Appeals 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
85.7
0mi
Updated: May 01
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
85.6
0mi
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
85.6
0mi
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
85.6
0mi
Updated: April 30
Manager II Grievance/Appeals (RN)
CERRITOS, 12900 PARK PLAZA DR
Maintains and coordinates staff activities to achieve departmental and corporate goals to improve service to customers/providers and assures regulatory compliance. - Analyzes and develops strategies by achieving performance thresholds within budgetary guidelines. - Addresses both internal/external cu...
Search Terms: Manager, Appeals, Administrative, Healthcare, Benefits
81.7
15mi
Updated: May 19
Nurse Appeals 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
79.6
15mi
Updated: May 01
Nurse Appeals 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
79.6
15mi
Updated: May 01
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