Appeals Specialist: Denial Resolution & Payer Strategies
Cross America Financial, LLC
Cross America Financial, LLC is seeking an experienced Appeals Specialist to challenge insurance denials, leveraging payer guidelines and state rules. You will prepare well-supported appeal arguments, contact payers, and monitor denials with attention to accuracy and deadlines. A background in hospital billing and familiarity with DMHC, CMS and Medicaid processes is preferred. The role demands strong research, communication skills, and the ability to manage multiple denials and follow up on #J-18808-Ljbffr Cross America Financial, LLC
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Appeals Specialist: Denial Resolution & Payer Strategies in Gardena, CA vacancy
- APPEALS SPECIALIST Do you like challenging payers? That feeling of satisfaction when your appeal is overturned? Then... ...versed in challenging insurance denials, utilizing payer guidelines and applicable... ..., general coding, and appeals resolution. Ability to read, analyze, and...SuggestedFull timeContract work
- ...Review Technician to coordinate the utilization review and appeals process within denial management initiatives. You will manage calls, data entry... ...with focus on maintaining audit integrity across RAC, MAC, CERT, and related payer reviews. #J-18808-Ljbffr Prime HealthcareSuggested
- Cedars-Sinai is seeking a Revenue Cycle Specialist III to support Hospital and... ...will handle complex cases, understand payer contracts, and serve as a technical resource... ...CS-Link, plus the ability to analyze denials and coordinate appeals, will help improve reimbursement and...Suggested
- ...Account Representative to handle billing, follow-up, and account resolution on a hybrid schedule (in-office 2 days, remote 3 days). Responsibilities include contacting payers, correcting accounts, appealing denials, and maintaining HIPAA-compliant records. Minimum 0-2 years...SuggestedWork at officeRemote work
$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 9... ...strong independent judgment. This position will provide resolution of complaints in compliance with Centers for Medicare and...SuggestedFull timeLocal areaRemote workShift workWeekend workL.A. Care Health Plan
Los Angeles, CA1 day ago- ...Revenue Cycle Specialist We are looking for an experienced Revenue... ...and insurance follow-up to denial resolution, payment posting, patient... ...understands healthcare billing and payer requirements, and knows how... ...Receivable, Denials & Appeals Follow up with payers...Work at office
Luskin Orthopaedic Institute for Children
Los Angeles, CA17 hours ago - ...Services is seeking a Care Management Recovery Advocate (CMRA) to oversee and streamline the appeals process between Providence Health and Services, CA Region and external payers. This role focuses on patient-centered, compliant activities that support reimbursement for...
- ...claims, failed claims/follow‑up resolutions, training, education, research, denial appeals, resolving unpaid medical claims... ...Medicare, Medicaid and third‑party payer guidelines. Ensures accurate... ...Certifications: Certified Coding Specialist (CCS) through governing body...Remote jobWork experience placementWork at office
$85k - $105k
...creating value through thematic investment strategies and delivering thoughtfully developed... ...billion. Position Summary The Strategy Specialist is Griffin Capital’s internal investment... ...), family and medical care leave or the denial of family and medical care leave, mental...Full timeTemporary workPart timeWork experience placementLocal areaRemote work- St. Francis Medical Center in Los Angeles seeks a Utilization Review Tech to coordinate the utilization review and appeals process within denial management initiatives. You will handle phone calls, data entry, and tracking with insurance providers and health plans. The...Work at office
$142k - $214k
...digital services.We're looking for a Lead, Strategy & Operations to join Snap! As a member... ...and reporting forms, escalation and appeals paths, and regional launches, translating... ...improvements in content discovery, self-serve resolution, automation rate, quality, and...Full timeLive inWork at officeLocal areaShift work- Syneos Health, Inc. is seeking a Clinical Value Liaison to engage payer decision-makers and communicate the clinical and economic value... ...scientifically grounded presentations that inform formulary decisions and HEOR strategies in a #J-18808-Ljbffr Syneos Health, Inc.
$100.16k - $218.72k
...Documentation Integrity and Denial Management team, including all... ...identify potential and active payer denials, assess clinical... ...denial prevention, analysis, and appeals across inpatient and outpatient... ...appropriate documentation strategies. Partnering with Medical Coding...University of California
Los Angeles, CA3 days ago$85k - $105k
Griffin Capital Corp. is looking for a Strategy Specialist based in El Segundo, CA or Remote. The role requires strong sales acumen with responsibility for advisor relationships and significant outreach efforts. The ideal candidate will have over three years of sales experience...Remote job$25 - $30 per hour
...Revenue Cycle Specialist Hot Job Gardena, CA 90249 Overview Salary Range $25.0... ...Research and follow up on billing and payment denials, holds, and other irregularities in a... .... Perform ongoing trend analysis of payer rejections and denials. Assist in...Hourly payFull timeContract workWork at officeShift workBehavioral Health Services, Inc
Gardena, CA1 day ago- ...Financial Partners Credit Union in Downey, CA is seeking a Loan Resolution Specialist to manage delinquent consumer loans and credit cards, communicating with members to arrange repayment solutions and restore accounts to good standing. The role emphasizes analytical problem...
Financial Partners Credit Union
Downey, CA1 day ago - Unisys in Los Angeles seeks a professional with arbitration and dispute resolution experience to manage a docket of cases, draft awards, and liaise with parties and arbitrators. The role emphasizes strong writing, client service, and timely delivery of resolutions. Ideal...
$24 - $26 per hour
...patient accounts to ensure full resolution and payment. Review and... ...rejected claims by initiating appeals or resubmitting corrected claims... ...with Epic and multi-payer environments Potential access... ...of our healthcare recruiting specialists will be in touch! #J-18808-Ljbffr...Weekly payContract workMonday to Friday- ...this role? The Revenue Cycle Specialist III works under general supervision... ...up on accounts to ensure resolution. Serves as liaison between... ...submit timely, accurate written appeals with supporting clinical /... ...documentations in accordance with payer guidelines. Maintain...Remote work
- Aptronics is seeking a YouTube Strategy and Optimization Specialist to develop and implement effective strategies aimed at maximizing channel growth and audience engagement. The role involves optimizing video release timing, crafting SEO-friendly titles, and managing large...Remote jobFull time
- Savills North America is seeking a Workplace Strategy professional to collaborate with brokers, clients and the Workplace Strategy team to design programs that optimize occupier experiences. This role emphasizes data-driven recommendations, space planning, and cross-functional...
- A cultural institution in Los Angeles is seeking a Metadata Strategies Specialist to lead and design metadata projects. The ideal candidate will have an MLIS and 5+ years of experience related to metadata and digital archives. This role requires strong knowledge of metadata...
- ...strategist in Los Angeles to help scale the TikTok Shop US initiative. You will analyze merchandise performance, lead cross-functional strategy, and drive programs that connect brands, creators, and shoppers. This role emphasizes analytics, risk management during rapid...
- A prestigious research institution in Los Angeles seeks an Authorities & Entity Management Metadata Specialist to enhance its metadata strategy. This role involves collaboration across departments focusing on data quality and governance. Candidates should have an MLIS and...
- Essex-Property-Trust is seeking an Account Resolution Specialist in the Woodland Hills, CA area to reduce resident delinquency and maximize revenue through effective collections. The role supports eviction and legal proceedings, communicates with residents and counsel,...Local area
- A national recruiting company is seeking a Business Grievance/Appeals Representative in Cerritos, California. The ideal candidate will review, analyze, and process claims, conduct investigations into customer grievances, and ensure proper communication with customers. Candidates...Contract work
- ...Los Angeles, CA is seeking a Revenue Cycle Specialist to join the Business Office and manage end... ...+ years in healthcare revenue cycle, Epic Resolute billing experience, and a detail‑oriented approach to payer requirements, denials, and patient billing. On-site role with a...Work at office
- Title: YouTube Strategy and Optimization Specialist Job Type: Full-Time Location Los Angeles strongly preferred (but open to remote) Responsibilities Develop and implement comprehensive YouTube strategies to maximize channel growth and audience engagement. Optimize...Full timeRemote work
- ...experienced Ambulance Billing Specialist who understands the... ...claims, resolve denials, work A/R, and... ...independently, understanding payer requirements, identifying... ...and submit effective appeals and reconsiderations... ...issues through to resolution What We're Looking...
MTI Ambulance
Los Angeles, CA23 days ago $28.01 per hour
...To provide customers with the highest quality service by providing consistent customer service and resolution in order to ensure timely release and/or inbound or outbound movement of freight/cargo. May proactively lead and guide team members ensuring successful achievement...Hourly payMinimum wageContract workLocal areaMonday to FridayFedEx Logistics
Gardena, CA8 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Appeals Specialist: Denial Resolution & Payer Strategies. Be the first to apply!
Related searches
- configuration specialist Gardena, CA
- localization specialist Gardena, CA
- ecommerce specialist Gardena, CA
- community health promotion specialist Gardena, CA
- infectious disease specialist Gardena, CA
- credit specialist Gardena, CA
- microbiology specialist Gardena, CA
- policy specialist Gardena, CA
- mental health specialist Gardena, CA
- restaurant specialist Gardena, CA