Healthcare Appeals Specialist

**About Blue Shield of California**Blue Shield of California is a health plan dedicated to providing high-quality, affordable healthcare services to our members. We are committed to improving the health and well-being of our community by delivering exceptional customer service, promoting healthy lifestyles, and supporting innovative healthcare...

About This RoleAs a Healthcare Advocate Coordinator at Blue Shield of California, you will play a critical role in managing and resolving member appeals and grievances in a timely manner.Your key responsibilities will include answering inquiries, investigating issues, and providing explanations of health plan benefits to members and providers. To succeed in...

Job SummaryWe are seeking an experienced Healthcare Operations Manager to join our team at Blue Shield of California.About the RoleThe ideal candidate will have a strong background in healthcare management, with experience in care coordination, utilization management, and quality improvement. The successful applicant will be responsible for ensuring that...

Our team is responsible for resolving member appeals and grievances in a timely manner.About the RoleThis role involves answering inquiries, investigating issues, and providing explanations of health plan benefits to members and providers.You will be working with our Appeals and Grievances team to ensure that all cases are resolved within established...

We are seeking a motivated Audiologist or Hearing Aid Specialist to join our team in the hearing industry.This full-time position offers a competitive base salary, a comprehensive benefits package, and opportunities for bonuses.HHR will disclose further details in conversation.Job OverviewHearing Healthcare Recruiters, LLC is a professional job placement and...

Overview">Mercy Medical Group, a leading multi-specialty medical group with over 500 healthcare providers in the Sacramento region, is seeking skilled and compassionate pediatricians to join our dynamic Pediatrics Department at our Cameron Park, CA clinic. As a pediatrician, you will play a crucial role in providing comprehensive medical care to infants,...

Join Blue Shield of California in a pivotal role as a Cloud Security Specialist, where you will play a crucial part in ensuring the security and quality of software products.Your primary responsibility will be to establish best practices and standards for DevSecOps methodologies, ensuring a secure and seamless transition to the cloud environment. You will...

Job OverviewA healthcare financial specialist is needed to join our team at Guidehouse. This role will focus on resolving account balances with patients and insurance companies, working closely with clients to ensure all policies and procedures are followed.About the RoleThis hybrid position offers a unique opportunity to work two days in the office and...

About UsBlue Shield of California is a leading healthcare organization dedicated to delivering high-quality, affordable care to its members.Job SummaryWe are seeking an experienced Supervisor, Operations for our Commercial Appeals & Grievances department. This role will be responsible for overseeing the daily operations and people management functions within...

Overview: Blue Shield of California seeks an experienced Operations Supervisor to lead the Commercial Appeals & Grievances department. This role is responsible for supervising coordinators, conducting research, and managing appeals and grievances.Responsibilities:Foster a collaborative work environment and develop high-performing teams.Manage routine...

Job SummaryThe Care Management team at Blue Shield of California supports the mission of providing support to patients in maintaining health and wellness in the outpatient setting. As a Senior Care Manager, you will report to the Manager of Care Management and ensure that services are provided based on standardized procedures, including coordination of care...

Company Overview:Onsite Women's Health is a mission-driven organization dedicated to improving women's healthcare through comprehensive mammography services.In partnership with forward-thinking providers, we offer personalized breast care solutions with clinical expertise and innovative technology.Salary: $120,000 - $150,000 per yearJob Description:We are...

Overview of the RoleAt Valmont Industries, Inc., we are seeking a highly skilled Industrial Welder Specialist to join our team in El Dorado, Kansas. This is a fantastic opportunity to work with a leading manufacturer of steel electrical poles and other structures.Compensation PackageThe successful candidate will be offered a competitive salary of $25.39 per...

We are seeking a dynamic and creative Senior Living Activity Director to join our team at El Dorado Estates, the premier retirement community for active seniors in El Dorado Hills.About the Position:This role is perfect for someone who has a passion for working with seniors and a proven history of event coordinating, decorating, wedding planning, or teaching...

At Blue Shield of California, we are committed to advancing the healthcare system in the state. As a Medical Director, Healthcare Optimization Specialist, you will play a crucial role in ensuring that our medical management team stays at the forefront of medical, medication, and payment policy.The successful candidate will report to the Senior Medical...

About UsBlue Shield of California is a critical member of the healthcare industry, providing innovative solutions for digital transformation and automation.Job SummaryWe are seeking an HR Technology Specialist, Senior to join our team. In this role, you will work with business leads on process definition, improvement, systems, performance, application...

Company OverviewAt Onsite Women's Health, we are committed to delivering comprehensive mammography services with clinical expertise and innovative technology. Our goal is to provide personalized, convenient breast care for patients, making it easier for them to remain compliant with their breast care.SalaryThe estimated salary for this role is $120,000 -...

About the RoleWe are seeking a skilled Strategic Provider Engagement Specialist to join our team at Blue Shield of California.Job SummaryThis role will focus on developing and maintaining strong relationships with healthcare providers, driving value-based care initiatives, and ensuring seamless operations across our pay-for-value payment models.Key...

Comprehensive Animal Healthcare at Veterinary Healing CenterWe are seeking a skilled veterinarian to join our team at Veterinary Healing Center in El Dorado Hills, California. As a dedicated animal care specialist, you will provide top-notch medical and surgical care to our small animal patients.About Our PracticeOur practice is committed to delivering...

About the Role:The Senior Case Management Nurse at Blue Shield of California plays a vital part in supporting patients in maintaining their health and wellness in the outpatient setting. This role involves developing personalized care plans, coordinating with specialists to ensure quality care, and ensuring compliance with medical necessity and clinical...