Appeals RN - Los Angeles

+Hospitals are hiring Appeals RNs in Los Angeles for day shifts with various job types available. · +RN Diploma degree or higher from an accredited school of nursing · Active and unencumbered Registered Nurse license in the state of California · + · ...

You could be the one who changes everything for our members as a clinical professional on our Medical Management/Health Services team. · ...

+The Grievance & Appeals Coordinator supports the resolution of member and provider grievances and appeals by analyzing claims, authorizations, and formal complaints. This role ensures timely, accurate case handling while maintaining high quality and compliance standards. · +- Re ...

The Grievance & Appeals Coordinator supports the resolution of member and provider grievances and appeals by analyzing claims, authorizations, and formal complaints. · ...

As we expand into California, we're seeking an experienced Property Tax Advisor to guide our team on navigating regulatory and operational requirements. · This is a contract-based, hourly consulting role ideal for someone who's an expert within California's property tax protestin ...

The writs and appeals unit of the Federal Public Defender represents indigent criminal defendants in their appeals to the Ninth Circuit Court of Appeals. · Reviewing records and brainstorming issues for appealDrafting memos on potential appeal issuesDeveloping appellate strategy ...

The Appeals and Grievances Lead is responsible for assisting with the development of a successful and cohesive Appeals and Grievance unit. · Providing direction to the team. · Handling internal or external questions or issues raised in relation to Appeals or Grievances. · ...

The writs and appeals unit of the Federal Public Defender for the Central District represents indigent criminal defendants in their appeals to the Ninth Circuit Court of Appeals and the U.S. Supreme Court. · ...

We're seeking an experienced Property Tax Advisor to guide our team on navigating regulatory and operational requirements in California. · ...

The Grievance & Appeals Regulatory Manager is responsible for working directly with providers in investigating and resolving cases. · ...

The Customer Solutions Center Appeals and Grievance (A&G) Training Specialist II is responsible for providing ongoing training on the core processing system, · A&G processing procedures, · training regulatory changes which will affect established procedures, · working with the qu ...

The Manager, Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the daily oversight of clinical appeals and grievances functions within the Appeals & Grievances Department to ensure clinical grievances... · ...

Leads and supervises team responsible for claims activities including reviewing and resolving member and provider complaints. · ...

The Care Management Recovery Advocate is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services. · ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy promoting productivity and work-life integration. · Supports clinicians to ensure timely and consistent responses to members and providers. · Provides guidance for clinical operational ...

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. You will perform individual case review for appeals and grievances for various health plan and insura ...

+6 months contract to hire position. · Responsible for processing and recording appeals and/or provider disputes as well as coordinating scheduling with internal and external PA reviewers for determinations and appeals. · Maintain a caseload of appeals, non-authorizations, provid ...

The Supervisor, Customer Solution Center Appeals and Grievances is responsible for direct supervision and support of the team responsible for the intake, research, resolution, tracking, trending and reporting within the Appeals and Grievances department. · ...

The Care Management Recovery Advocate is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services California Region PH&S outside payers.Activities will be patient-focused uniform compliant and support steadf ...

Supports claims activities including reviewing and resolving member and provider complaints. · Facilitates comprehensive research and resolution of appeals. · Researches claims appeals using support systems to determine appropriate outcomes. · ...