Clinical Documentation Specialist CDI Healthcare

Immediate need for a talented Appeals and Grievance Coordinator in California. This is a 06+ months contract opportunity with long-term potential and is located in Los Angeles, CA (Remote). Please review the job description below and contact me ASAP if you are interested. 

Job ID: 25 65809

Pay Range: $26 - $30/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Manage and investigate member appeals and grievances received via email and phone.
• Review and evaluate claims and medical billing documentation to support appeal decisions.
• Ensure all cases are handled in compliance with regulatory standards and internal policies.
• Accurately document communications and outcomes within case management systems.
• Communicate clearly and empathetically with members to resolve concerns efficiently.

Key Requirements and Technology Experience: 

• Key Skills- Strong Case management experience with Inpatient acute care (Hospital) Experience within Appeals and Grievance, Utilization and conducting investigations.
• RN Case Manager
• Hospital setting
• Acute care
• InterQual
• RN active Lincense

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy 

.

#St J2W:CB3