Job Seekers, Welcome to Health Career Center
Search Filters
Use this area to filter your search results. Each filter option allows for multiple selections.
Foundation Health Partners
Fairbanks, Alaska
Jackson Physician Search
California
CompHealth
Seattle, Washington
CompHealth
Raleigh, North Carolina
Vanderbilt Health
Nashville, Tennessee
Loading... Please wait.
Details
Posted: 14-Dec-24
Location: Los Angeles, California
Categories:
Admin / Clerical
Internal Number: 145209342
DescriptionAs the Appeals and Grievances (A&G) Analyst, you will be responsible for assisting with all operational aspects of appeals and grievances, in accordance with state and federal regulations. You will:
- Manage various weekly/monthly deadlines effectively due to the time constraints imposed by CMS on Medicare appeals and grievances.
- Collaborates closely with beneficiaries, healthcare providers, and insurance companies to ensure that complaints, appeals, and grievances are addressed in a timely manner.
- Analyze and process appeals and grievances in accordance with CMS/Medicare regulations and guidelines.
- Investigate complaints and work with all parties involved to find a resolution in accordance with CMS/Medicare regulations and guidelines.
Salary: $31.45 - $43.17/hourly
Qualifications
We’re seeking a detail-oriented, self-directed individual with:
- Three or more years of experience in a Medicare or Managed Care, specifically benefits, enrollment/disenrollment & grievances and appeals process, required
- Knowledge of Medicare and CMS regulations, required
- Strong knowledge of the health care model and other managed care MSO operations, required
- Strong familiarity with CMS requirements and regulations pertaining to appeals and grievances
- Knowledgeable of physician and facility billing practices, appropriate CPT coding initiatives, ICD-10 coding standards, as well as Revenue and HCPCS coding
- Working knowledge of Microsoft Office Suite (i.e., Word and Excel), and Visio and data visualization tools, required
- Reliability and compliance with scheduling standards
- Strong ability to research and resolve issues
About UCLA
More Jobs from This Employer
https://jobs.healthcareercenter.com/jobs/20894495/appeals-and-grievances-analyst
Loading. Please wait.