- Carrington (Anaheim, CA)
- …Recovery Advances ("MRA"). Assists with clearing Title issues related to Partial Claims . Provide reporting as requested by Manager /Supervisor on loan status. ... Perform all duties in accordance with the company's policies and procedures, all US state and federal laws and regulations, wherein the company operates. The approved pay for this position is $20.50. **What you'll do:** + Receive, review, and assign… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …offices), answering the phone (including all provider calls regarding authorization processing, claims related phone calls, and any other calls received via the ... codes, CPT Codes, HCPC Codes, Health Plan benefits, or claims **The current salary range for this position is...remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool… more
- CVS Health (Sacramento, CA)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... and the team is highly collaborative. You will report to the Senior Reporting Manager within the Compliance Pharmacy Payments team. To be successful in this role,… more
- Elevance Health (Costa Mesa, CA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Humana (Sacramento, CA)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- UIC Government Services and the Bowhead Family of Companies (San Diego, CA)
- …+ Lab Management Specialist + Automated Cloud Services Specialist + Project Manager Bowhead seeks to network with qualified individuals relative to a potential ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- Financial Partners Credit Union (Downey, CA)
- …and/or collateral. + Recommend accounts for legal action or repossession to the manager for approval. + Assign accounts for field chase when necessary. + ... Documentation and Claims : + Review and follow up on letters of...letters of guarantee with insurance companies. + File GAP claims and process cancellations of warranties when applicable. Education… more
- Cedars-Sinai (Beverly Hills, CA)
- …with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the ... processing authorizations. + Contacts facilities identified by the UM Nurses/ Manager /Director/Medical Director to research any issues (ie contract, discharges,… more
- LA Care Health Plan (Los Angeles, CA)
- …collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory ... within 2 hours of receipt; identify duplicate requests using the claims and verify existing authorization. Independently identifying and appropriately returning to… more
- Utilities Service, LLC (Redding, CA)
- …the crew. + May be delegated the authority to investigate incident reports, damage claims , etc., and to settle minor damage claims . + Maintains accurate records, ... benefits available for this role, please contact the recruiter or hiring manager . **Individuals with a disability who desire a reasonable accommodation can contact… more