Experience

NAMM California

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Denial, Appeal and Grievance Manager, LVN

  • Mar 2021 - Present

  Ontario, California, United States Supervise Denial and Appeals Coordinators, Manage Denial Queue, Logging CCG and PQI, Processing QIO and Pre-Service Appeals, Denial Training, Crafting Denial Language and Plain Language. Data Entry and Review Reports for Appeals, Denials and Grievance Compliance Requirements. Data Entry and Review Appeal Determination Report.

• Denials and Appeals Supervisor, LVN

  • Aug 2014 - Mar 2021

  Ontario, California Supervise Denial and Appeals Coordinators, Manage Denial Queue, Logging CCG and PQI, Processing QIO and Pre-Service Appeals, Denial Training, Crafting Denial Language and Plain Language.

• Denial/Appeal Coordinator

  • Nov 2010 - Aug 2014

  Pre-Service Denial Letters, Denial Language, Pre-Service Appeals, Access Audit Calls, Internal IPA Audits, Health Plan Audits, SCAN Monthly Audits



Pacific Hospice/Anchor Medical Group

• Lvn

  • Mar 2014 - Apr 2014

  EZ Cap, Wound Care, EOC, Supply Sign Off, Authorization



Dr. Robert J. Kirshbaum, MD

• Certified Medical Assistant

  • May 2006 - Nov 2010

  Referral Coordinator, Front Office, Back Office, Urinalysis, Blood Stool Occult, DOT, EKG, Stress Test, Phone Calls, Appointment Schedule, Assist Skin Biopsy, Assist PAP Smear, Rooming Patient, Filing