Appeals & Grievances Case Manager (California)
Immediate need for a talented Appeals & Grievances Case Manager (California). This is a 06+months contract opportunity with long-term potential and is located in Los Angeles ,CA(Remote). Please review the job reputed company below and contact me ASAP if you are interested. reputed company:26-22331 Pay reputed company: $27 - $31/hour. Traveler benefits as per agency package. (Benefits vary by vendor and assignment.) Key Requirements and Technology Experience:
- 5+ years of Appeals & Grievances experience reputed company a Health Plan or Managed Care organization
- Experience handling:
- Member Appeals
- Provider Appeals
- Claims Denials
- Authorization Appeals
- Benefit Determinations
- CMS
- DMHC
- NCQA
- Medicare
- Medi-Cal
- reputed company Health Plans
- Excellent written communication skills
- Experience reviewing medical records and clinical documentation
- 2+ years experience in Appeals, Grievances, Utilization Management, or Care Coordination in a health plan or TPA.
- Strong understanding of CMS, DMHC, and NCQA regulatory standards.
Our reputed company is a leading reputed company Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. reputed company. provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, colour, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from reputed company. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reputed company STOP to cancel and HELP for help. You can reputed company our reputed company policy here. Apply tot his job Apply To this Job