Appeals Processing jobs in Santa

A company is looking for an Appeals Representative responsible for reviewing claims denials and preparing documentation for appeals. Key Responsibilities Review assigned denials to determine appropriate action based on payer requirements Assemble and prepare required documentation for appeal in the

Are you ready to lead a high-impact team handling legal appeals, training staff, solving case issues, and ensuring accuracy in legal processing? Join us as an Appeals Clerk III, where your attention to detail, problem-solving skills, and leadership will shape justice behind the scenes. The ideal can

JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Med

Are you ready to lead a high-impact team handling legal appeals, training staff, solving case issues, and ensuring accuracy in legal processing? Join us as an Appeals Clerk III, where your attention to detail, problem-solving skills, and leadership will shape justice behind the scenes. The ideal can

A company is looking for a Supervisor, Appeals and Grievances for Medicaid. Key Responsibilities Oversee daily operations and facilitate the work of team members Lead the Appeals efforts, providing oversight, training, and guidance to the team Conduct in-depth investigations and documentation of mem

A company is looking for a Clinical Analyst Appeals (Remote). Key Responsibilities Manage clinical appeals, audits, and compliance reporting to ensure adherence to regulations Prepare and defend appeal requests for claims denials and adverse audit results Conduct audits and provide recommendations f

Lucid Diagnostics

REIMBURSEMENT SPECIALIST, APPEALS: We are looking for an enthusiastic, detail-oriented Reimbursement Specialist, Appeals to join our RCM team and support post-claim submission activities. The Reimbursement Specialist, Appeals role is responsible for managing denials, preparing and submitting appeals

Molina Healthcare

Claims Support Specialist Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medic

Are you ready to lead a high-impact team handling legal appeals, training staff, solving case issues, and ensuring accuracy in legal processing? Join us as an Appeals Clerk III, where your attention to detail, problem-solving skills, and leadership will shape justice behind the scenes. The ideal can