Healthcare Grievance & Appeals Specialist
AppleOne Employment Services
AppleOne Employment Services seeks a Grievance and Appeals Specialist to analyze and process non-complex health plan grievances and appeals with a focus on regulatory alignment and clear written communication. You will review cases from members, providers, and third parties within a structured framework. The position offers cross-functional collaboration, training, and exposure to URAC/NCQA standards, requiring strong writing and analytical abilities in a compliant environment. #J-18808-Ljbffr AppleOne Employment Services
$60.78k
...Appeals And Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $60,778.00 (Min.) - $91,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent...SuggestedFull timeLocal areaRemote workShift workWeekend work$27 per hour
...Description Job Description Job Summary We are seeking Grievance and Appeals Specialists who enjoy research, documentation, regulatory accuracy,... ...: - Review, analyze, and process non-complex healthcare grievances and appeals from members, providers, regulatory...SuggestedHourly payContract workTemporary workFlexible hours- ...Job Description Job Description APPEALS SPECIALIST Do you like challenging payers? That... ...accurately. Filing complaints and grievances through the DMHC, DOI, DOL, CMS and... ...they may continue to provide critical healthcare services to their patients. Our team members...SuggestedFull timeContract work
- ...To establish and maintain excellent relationships with the healthcare provider network in a specific geographic region, including... ...issues. Assists with research and disposition of provider appeals and grievances. Identifies network gaps and performs recruitment to address...SuggestedWork at office
- ...inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional... ...as possible. Position Summary : The Associate Trauma Specialist will work together with the Trauma Territory Manager and will...SuggestedFull timeNight shift
$7.5k - $17k
...Company Description NS Healthcare connects skilled candidates with the best companies in the area. We take pride in understanding a candidate’s skill set, experience and needs and then pairing them up with the right organization. Job Description RECRUITER...Full timeContract workReliefRemote work- ...Summary The PACE Utilization Review Specialist – RN oversees clinical utilization management... ...management processes and provider appeal reviews. Document all utilization management... .... Knowledge of State and Federal healthcare regulations, quality standards, and...Work at office
$85.8k - $98k
...and motivated Environmental Health and Safety (EHS) Consulting Specialist to join our dynamic EHS team in Irvine, CA. This position is... ...experience supporting laboratory, biotechnology, pharmaceutical, healthcare, or other regulated environments Working knowledge of...Temporary workLive in- ...access to culturally and linguistically-sensitive quality primary healthcare and human services support to the underserved and uninsured... ...of Southern California.Assignment SummaryThe Utilization Specialist at Kheir Clinic plays a critical role in ensuring that patients...Local area
$125k - $135k
...a positive impact on patients' lives? Do you have Electronic Healthcare Record (EHR) experience and are looking for a rewarding career... ...currently we are looking for Health Information Technology Specialists to support an IQVIA pharmaceutical client partnership.This individual...Full timePart timeImmediate startWorldwide- ...Summary The Vocational Rehabilitation Specialist (VRS) position is located in the Community Engagement and Reintegration Service... ...Development (VCED) department, of the VA Greater Los Angeles Healthcare system (VAGLAHS). The incumbent is assigned vocational rehabilitation...Permanent employmentFull timePart timeWork experience placementSeasonal workWork at officeLocal areaTrial periodRelocation package
$86.9k - $109k
...Sonography / Ultrasound Specialist Los Angeles, CA $86,900 - $109,000 a year Scan with Intention in the City of Angels: Where Artistry... ...this role offers you the chance to be a part of an impactful healthcare team. Position Overview We are on the lookout for a...Local areaFlexible hoursWeekend workDay shiftAfternoon shift- ...The Genomics Core is looking for a Biomedical Specialist to join the team! The Cedars-Sinai Applied Genomics, Computation, and Translational... ...assigned. Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research....
$250k - $350k
...Thrive Pet Healthcare is seeking an additional Veterinary Internal Medicine Specialist to join the exceptional team at ACCESS Specialty Animal Hospitals in Culver City! Join a collaborative community of veterinary care providers with the support, tools, and resources...Flexible hours3 days per week$72.07k - $90.99k
A healthcare organization is seeking an Enrollment Development Specialist I (EDS I) in Los Angeles, CA. The EDS I focuses on conducting marketing events to boost PACE awareness. Ideal candidates will have a Bachelor's degree and at least 2 years of outreach experience....- A leading healthcare organization in Lynwood, California, is seeking an Enrollment Development Specialist I to support marketing initiatives for the Program of All-Inclusive Care for the Elderly (PACE). The role focuses on raising awareness in senior communities, developing...
$23 - $25 per hour
...the United States and, in so doing, ensures the high quality healthcare offered by its affiliates. The local and national organizations... ...Pasadena and San Gabriel Valley, Inc. The Front Office Specialist is the face of PPPSGV and responsible for supporting the delivery...Contract workWork at officeLocal areaFlexible hoursShift workAfternoon shift$96k - $154k
...the U.S. Trusted by more than 25 million consumers and 750,000 healthcare professionals annually, GoodRx provides access to savings and... ...Americans. About The Role GoodRx is seeking a Sr. Paid Social Specialist to manage and optimize digital media campaigns that drive customer...Temporary workWork at office- ...exceptional, dedicated professionals who are passionate about advancing healthcare. Our physicians, nurses, and staff reflect the culturally and... ...impact how we diagnose and treat disease. The Biomedical Specialist participates on wet‑ and dry‑laboratory projects and may...
- A community healthcare provider in Los Angeles is seeking a Customer Service Specialist. This role involves offering excellent customer service and assisting patients with inquiries. The ideal candidate should be bilingual in English and Spanish, possess strong communication...Full time
- ...to share an exciting and challenging opportunity for a Crisis Specialist 40 or 30 hour positions, West Valley. Terros Health’s Crisis... ...self-starter, organized, and compassionate. Terros Health is a healthcare organization of caring people, guided by our core values of...Hourly payFull timeImmediate startShift workWeekend workAfternoon shift
- UCLA Health seeks a transformative leader to drive performance improvement across its health system. You will collaborate with clinical and operational teams to deliver Lean-based initiatives, develop teams, and sustain change, advancing patient experiences and care quality...
- ...Responsibilities BHC Alhambra Hospital Patient Transportation Specialist Weekend Per Diem* Able to work Saturdays and can cover when needed... ...nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily...Daily paidLocal areaFlexible hoursWeekend work
$20 - $25 per hour
A healthcare organization is seeking a Case Management Coordinator I in Monterey Park, CA. This role involves assisting case managers, coordinating discharges, and managing authorization requests. The ideal candidate should have at least a high school diploma, with 2 years...Hourly pay- A healthcare services organization in Los Angeles is seeking a Payment Posting Specialist to ensure timely posting of payments and adjustments. The ideal candidate will have over two years of relevant experience and excellent attention to detail. Responsibilities include...Full time
$21.84 - $34.48 per hour
Keck Medicine of USC in Los Angeles, CA is seeking an EVS Worker for a full-time 8-hour evening shift in a union environment. The role focuses on cleaning, infection control, waste handling, and patient-area support within a hospital setting. The position requires basic...Hourly payFull timeAfternoon shift- A leading healthcare provider in California is looking for a Patient Access Center Representative to manage appointment scheduling and ensure financial clearance for patients. This role requires a high school diploma and ideally, experience in a healthcare setting or customer...Full time
- ...designation for nursing excellence. From working with a team of premier healthcare professionals to using state–of–the–art facilities, you'll... ...other week. As a full–time Pharmacogenomics Pharmacist Specialist at Cedars–Sinai Medical Center in Los Angeles, California is...Full timeRemote workMonday to FridayWeekend workDay shift1 day per weekWeekday work
- ...Direct Jobs is seeking a full-time Pharmacogenomics Pharmacist Specialist at Cedars-Sinai Medical Center in Los Angeles, California.... ...program, optimizing medication therapy, and collaborating with healthcare professionals for improved patient outcomes. The ideal candidate...Full timeRemote work1 day per week
- Tenet Healthcare's DMC Huron Valley-Sinai Hospital is seeking a Patient Access/Admitting professional to register patients, verify insurance, and coordinate data across ancillary services. You will support pre-registration, ensure accurate demographic and billing information...ReliefDay shift
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