Jesse Casillas
Analyst at Community Health Group
- Role
- Grievance and Appeals Analyst at Community Health Group
- Location
- San Diego, CA, US
- LinkedIn followers
- 500 followers
About Jesse Casillas
Great honesty and integrity comes out of me. I bring an energetic personality with lots…
Experience
Grievance and Appeals Analyst
May 2024 — Present · San Diego, CA, US
During work, I interact with our members, clinicians, specialists, and doctors. New cases are delivered each day. Each one with a time frame to resolve. Measuring the importance of each case is required to determine proper management. Each case can be standard, dismissed, or expedited. Investigations are conducted to gain required information for each case. Communication between parties is crucial for each response. An acknowledgment letter is sent when the case is opened. Followed by a resolution letter once the case is closed. Each letter has to be approved and signed off by one of our medical doctors before it mails out. Being organized with complete documentation is important for state auditing purposes. Each case is individually post-close audited. This is done by monthly audits where cases are delivered and personally reviewed to perfection.
Education
California State University San Marcos
Bachelor's degree, Communication
2015 — 2019
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