- Molina Healthcare (San Diego, CA)
- …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
- Cardinal Health (Fresno, CA)
- …Collector is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... + Contact insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues. + Analyze denials and underpayments… more
- Travelers Insurance Company (Sacramento, CA)
- …key decisions. You will be working with the Pricing, Product, Underwriting, and Claims teams to both learn the business and communicate your findings and ... B&SI reserving team embraces innovative methods, such as advanced claim level models, you'll play a key role in...the Financial Institutions business unit. + Work with the Claims department to ensure best estimates are appropriately reserved… more
- Travelers Insurance Company (Sacramento, CA)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical environment… more
- Sedgwick (San Francisco, CA)
- …Adjuster - Pacific Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... including handling accounting-based losses (business interruption and stock). + Examines claim forms and other records to determine insurance coverage. + Interviews,… more
- Movn Health (CA)
- …Senior Medical Biller & A/R Specialist to take full ownership of claims processing and accounts receivable recovery. This is a hands-on, senior-level role ... self-starter with a proven track record in A/R recovery, claim appeals, and payer follow-ups. Experience in startup environments...payer systems is essential. Functional Responsibilities + Submit clean claims via EHR to all payers within 24 hours… more
- Allied Universal (Fairfield, CA)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
- UCLA Health (Los Angeles, CA)
- …Maintain compliance with government regulations, reimbursement issues, etc. + Analyze hospital billing claims within the EHR and claim scrubber system + Resolve ... Excel + Knowledge of Tableau Reporting dashboards + Understanding of Medicare/Medi-Cal claims processing guidelines + Experience with EPIC EHR, Cirius Claim … more
- Cardinal Health (Fresno, CA)
- …revenue by monitoring and pursuing payment for all unpaid and delinquent denied claims . They also act as a liaison between the provider, payors, and patients ... the LCD/NCD requirements. + Identify trends that inhibit timely claim submission for all centers. + Work closely with...interchange and the life cycle of primary and secondary claims . + Contribute to team efforts by accomplishing related… more
- Centene Corporation (Sacramento, CA)
- …fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare ... mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect...related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, medical … more