- Molina Healthcare (CA)
- …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances , and/or complaints from Molina members, providers, ... that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I primary function is to learn the specialty… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve… more
- LA Care Health Plan (Los Angeles, CA)
- …Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: ... call documentation and categorization, service authorization request and coverage determination , Appeals and Grievances across all lines of business). This… more
- J&J Family of Companies (San Diego, CA)
- …eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals / grievances ); REMs certification; Medicare and Medicaid rules and ... We are searching for the best talent for Neuroscience Area Business Specialist to be in South California. **About Neuroscience** Our expertise in Innovative… more
- The County of Los Angeles (Los Angeles, CA)
- …personnel in their unit and effectively recommending the adjustment of grievances and disciplinary problems. Other positions are assigned such functions as: ... first level technical and administrative supervision to the complaint or advanced-level appeals unit. Essential Job Functions + Supervises the activities of all… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …and resolution of facts and issues in matters affecting disciplinary actions, grievances , appeals , and complaints, refers complex matters to HR Employee ... Relations Specialist or Senior Manager of Employee Relations as required...work with 30%dedicated time committed to handling employee complaints, grievances , interactive processes, and disciplinary actions. + Experience with… more
- Cedars-Sinai (Beverly Hills, CA)
- …the payor + Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate ... + Coordinates discharge planning and alternative treatment plans with PCP/hospitalist/ specialist as appropriate. + Coordinates the patient's care with other… more