Advanced Provider Dispute Resolution Coordinator

{"title": "Advanced Provider Dispute Resolution Coordinator", "subtitle": "Join Blue Shield of CA", "content": "At Blue Shield of CA, we are seeking an Advanced Provider Dispute Resolution Coordinator to join our team. In this role, you will be responsible for researching, reviewing, and resolving high-level/high-priority provider grievances, appeals, and...

Job Description**Role Overview**The Claims Examiner III is a critical position within the Advanced Medical Manage organization, playing a vital role in the Claims Department. This role requires collaboration with the Claims Team to meet productivity goals and ensure quality. The ideal candidate will possess claims knowledge, prioritization skills, and the...

About Us:At Ascendion, we are a reputable law firm dedicated to providing top-notch legal services to clients in a wide range of practice areas. Our firm is known for its commitment to excellence, integrity, and client advocacy.Qualifications: Juris Doctor (JD) degree from an accredited law school. Active membership in good standing with the State Bar of...

Job DescriptionJob Summary:We are seeking a highly motivated and detail-oriented Contract Administration Specialist to join our team at Advanced Medical Manage. As a Contract Administration Specialist, you will play a critical role in managing and overseeing the contract administration process for our company.Key Responsibilities:Coordinate the contract...

Job OverviewPOSITION SUMMARYThe Provider Engagement Coordinator, reporting to the Director of Provider Engagement, plays a crucial role in supporting the operations of IPA Regional Networks. This position is essential for facilitating communication between client leadership and healthcare providers, addressing physician concerns, and collaborating with...

Job OverviewPOSITION SUMMARYThe Provider Engagement Coordinator reports directly to the Director of Provider Engagement. This role is essential in assisting the Provider Engagement Department with the operational management of IPA Regional Networks. Responsibilities include effective communication with client leadership and physicians, addressing physician...

Job OverviewPOSITION SUMMARYThis role reports directly to the Director of Provider Engagement. The individual will play a crucial role in assisting the Provider Engagement Department with the management of IPA Regional Networks. Responsibilities include effective communication with client leadership and physicians, addressing physician concerns, and...

Job DescriptionWe are seeking a highly organized and detail-oriented Contract Coordinator to join our team at Advanced Medical Manage. As a Contract Coordinator, you will play a critical role in managing and overseeing the contract administration process for our company.Key Responsibilities:Coordinate the contract administration process, including drafting,...

Job Description**Role Overview**The Claims Examiner III is a critical position within the Advanced Medical Manage organization, playing a vital role in the Claims Department. This role requires collaboration with the Claims Team to meet productivity goals and ensure quality. The ideal candidate will possess claims knowledge, prioritization skills, and the...

Job SummaryWe are seeking a highly skilled and experienced Senior Collections Manager to join our team at American President Lines. As a key member of our finance department, you will be responsible for managing collections of CMA CGM Group revenues in the USWC and monitoring staff performance to reduce DSO, past due, and risk exposure.Key...

Job DescriptionRole OverviewThe Claims Examiner III is a critical role within the Advanced Medical Manage team, responsible for ensuring the quality and accuracy of claims processing. This position requires a strong analytical mind, excellent problem-solving skills, and the ability to work effectively in a fast-paced environment.Key ResponsibilitiesAudit...

Job OverviewPosition SummaryThe role of a Care Coordinator is vital within the Advanced Medical Management organization and its Care Management Department. This position is dedicated to facilitating telephonic patient support in accordance with AMM guidelines and in partnership with the Care Management Team. The ideal candidate will exhibit a positive...

Job OverviewPosition Title: Benefits Analyst IPosition Summary:The Benefits Analyst I plays a crucial role in assisting with all facets of benefits configuration. This includes programming, reviewing, and auditing benefit setups to ensure accurate programming for authorizations and claims.Key Responsibilities:Utilize Health Plan websites to gather benefits...

Job OverviewPosition SummaryThe role of a Care Coordinator is pivotal within the Advanced Medical Management organization and its Care Management Department. This position entails providing telephonic support to patients, adhering to the guidelines set forth by AMM, and collaborating closely with the Care Management Team. The ideal candidate will embody a...

Job OverviewPosition SummaryThe Care Coordinator plays a pivotal role within the Advanced Medical Management organization, specifically within the Care Management Department. This position is tasked with facilitating telephonic patient support in accordance with established guidelines and in collaboration with the Care Management Team. A positive demeanor,...

Your RoleThe Advanced Social Services Coordinator offers telephonic support and resource referrals to Blue Shield Promise members, while also providing administrative assistance to the Social Service Behavioral Health Care Management Team and their supervisors. The Coordinator frequently engages with members and their families to assess social service and...

Job SummaryMolina Healthcare is seeking a highly skilled and experienced Director, Appeals to lead the Appeals and Grievances Unit. The successful candidate will be responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by...

Job SummaryThe Professional Services Support Manager plays a pivotal role in overseeing the Professional Services Support department's personnel, activities, and functions. This individual partners closely with executive management, Operations, Professional Services field personnel, Sales personnel, Member Services, and other teams to ensure all professional...

Job SummaryThe Los Angeles County Bar Association - LACBA seeks a senior labor and employment attorney with 7+ years of litigation experience in labor and employment law. The ideal candidate will provide exceptional legal counsel on labor and employment-related matters, including:Human resources issues and complianceWage and hour law and...

Job SummaryThe Eligibility Coordinator plays a critical role in maintaining accurate and up-to-date member data in EZ-CAP. This position is responsible for ensuring the integrity of eligibility information, resolving inquiries, and communicating outcomes to internal departments.Key ResponsibilitiesVerify member eligibility, including coordination of...