Jobs near Anaheim: 11,502
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Relevance Score ranked on: APPEALS
Senior Manager Appeals and Grievances - QUALITY ASSURANCE
Anaheim
The Senior Manager Appeals and Grievances has direct responsibility for the design, implementation and ongoing operations of the Health Plan Grievances and Appeal process for California. This position directs and ensures the efficient operational management of health plan appeals and grievances with ...
Search Terms: Manager, Quality Assurance, Appeals, Medical Director, Senior
86.5
0mi
Updated: October 22
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
84
12mi
Updated: October 31
Appeals and Grievances Medical Director - Hospitalist or Internal Medicine - 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, Hospitalist, Director, Appeals, Internal
81.2
5mi
Updated: October 02
Appeals and Grievances Medical Director - Radiology 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, Radiology, Director, Appeals, Medical
81
5mi
Updated: September 27
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
81
5mi
Updated: September 27
Appeals and Grievances Medical Director - Radiology 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, Radiology, Director, Appeals, Medical
80.8
5mi
Updated: September 21
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
80.8
5mi
Updated: September 21
Lead Pharm/PA Appeals Technician - National Remote
Costa Mesa
Review team stats/adherence (NICE app) and provide feedback on individual and team progress. Lead should be included in all communication with team members. Open communication is important for consistency and success Apply knowledge/skills to complex activities Remain available to staff to answer que...
Search Terms: Technician, Pharmacy Technician, Appeals, Lead, Remote
77.1
12mi
Updated: October 09
Customer Service Representative (Inside Sales)
Anaheim
Under close supervision, the Customer Service Representative is responsible for accurately fulfilling customer orders and managing incoming customer calls. JOB DUTIES: - Responds to basic customer inquires regarding products, provides quotes, and handles order entry. - Places customer orders via tele...
Search Terms: Customer Service Representative, Customer Service, Inside Sales, Representative, Counter Sales
0
0mi
Updated: October 31
Room Attendant
Anaheim
The Room Attendant (RA) works with the Housekeeping Management Team to clean guest rooms and public space areas, and/or work in the commercial laundry facility, in accordance with brand time, product and placement standards to ensure total guest satisfaction. Job Description. DUTIES AND RESPONSIBILIT...
Search Terms: Room Attendant, Attendant, Hotel, Cleaning, Supervisor
0
0mi
Updated: October 31
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