A fantastic opportunity has just become available for an experienced Case Manager Clinical Appeals at a top-rated short-term acute care hospital in warm, sunny Southern California.
The Case Manager Clinical Appeals will review denied claims and process payer appeals to recover payment. The Case Manager Clinical Appeals will review an assigned caseload, obtain information as needed, file clinical appeals, and communicate clinical denials to appropriate departments to minimize future denials.
Reporting to the Nurse Manager of Case Management and Utilization Review, the Case Manager Clinical Appeals will collaborate with the Director of Case Management and Denials Manager. The Case Manager Clinical Appeals is also accountable for escalating special cases to the Medical Director as necessary.
This top-rated teaching hospital is respected nationwide for offering top-rated patient care. This medical center offers comprehensive services including inpatient and outpatient care, medical and surgical services, diagnostic and emergency care.
Clean air and a warm Mediterranean climate make this the perfect spot to enjoy endless recreational activities in the beautiful outdoors. This friendly community is just a short drive away from National Forests and some of the best outdoor recreation California has to offer. Affordable cost of living, strong school districts, and a safe, lively downtown area make this the perfect home for the Case Manager Clinical Appeals.
This respected medical center is prepared to offer the qualified Case Manager Clinical Appeals a competitive salary and comprehensive range of benefits, including relocation assistance, full medical/dental/vision insurance, free parking, and generous retirement plan matching.