- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Payment… more
- Ventura County (Ventura, CA)
- …(III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, ... Manual and TAR process, they ensure timely, compliant submissions that support access to behavioral health services. They communicate effectively with peers,… more
- Molina Healthcare (Fresno, CA)
- **JOB DESCRIPTION** **Job Summary** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and ... to improve our member and provider experiences. **Job Duties** * Provide service support to members and/or providers using one or more contact center communication… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Division Support Specialist Under the general supervision of the Supervisor, Professional Billing & Coding, responsible for compiling & providing daily, ... weekly & monthly data to Supervisor for the Specialties that they support . Will monitor & report on work queue activity, encounter management, monitor electronic … more
- Oracle (Sacramento, CA)
- **Job Description** Oracle Clinical AI Assistant (CAA) allows providers and their support staff to focus more on patient care by reducing administrative burden of ... this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical...1-2 years of experience in hospital audits preferred + Associate or bachelor's degree in nursing from an accredited… more
- HUB International (Fresno, CA)
- …decision-making. The Account Manager II also supports Producers and other support staff in obtaining, maintaining, and expanding business. **DUTIES & ... the service they need to properly manage their insurance policies. Performs general support functions to keep insurance policies in-force and active. + Works closely… more
- Humana (Sacramento, CA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to… more
- LA Care Health Plan (Los Angeles, CA)
- …for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Care ... or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document… more
- Humana (Sacramento, CA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... + Bachelors Degree + Minimum of 3 years of medical claims auditing experience (interpreting if claims initially paid correctly in the system) + Minimum of 2… more
- Cognizant (Sacramento, CA)
- …United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs. **Location:** ... : 2-3 years in healthcare revenue cycle. + **Education** : HS Diploma. Associate or bachelor's degree preferred. + **Technical Skills** : Proficiency in Excel, payer… more