- Sharp HealthCare (San Diego, CA)
- …and oversees the health care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief Medical Officer. Is accountable for ... with medical management such as provider relations, member services, benefits and claims management, etc. Assists (as determined by the plan Chief Medical Officer)… more
- Zurich NA (Gold River, CA)
- …talent at any Zurich office location. We may, at the sole discretion of the Hiring Manager , be open to hiring remote talent This role will be filled at either the ... Liability Underwriter or VP, Construction Professional Liability Underwriter. The hiring manager will determine the appropriate level based upon the selected… more
- Allied Universal (San Francisco, CA)
- …flexibility meets opportunity. As a Flex Part-Time Security Officer, you'll use our exclusive Claim a Shift platform to view and Pick up open shifts based on your ... You'll Do:** + Use our proprietary scheduling platform to claim open shifts at client sites + Support operations...enforcement experience, or 2 years of security supervisor or manager experience, or 3 years of security-related experience. +… more
- Elevance Health (Los Angeles, CA)
- …analysis and expanding reporting. This role will center around mining complex claims , diagnosis, eligibility and patient data for valuable insights and then ... will make an impact:** + Serving as a subject-matter-expert on claims , eligibility, authorization and assessment datasets. + Tackling wide-reaching ambiguous data… more
- Empirical Systems Aerospace, Inc. (San Luis Obispo, CA)
- …project reports and make presentations at meetings + Support negotiations of claims , manage contractual changes and resolve disputes or conflict resolution with ... Contractors and Customers + Assess and prepare claims from suppliers + Manage contract closeout procedures +...management, business management, procurement, law or a related field preferred + A minimum of 5 years' experience in… more
- Walgreens (Gilroy, CA)
- …Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Evolent (Sacramento, CA)
- …to find the most valuable defects. The IQA reports to a associate director or a manager . One or many IQAs may be engaged in any testing effort **What You Will Be ... risks and issues in coordination with the lead / manager for status reporting + Responsible to enforce department...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Walgreens (San Bruno, CA)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Sharp HealthCare (San Diego, CA)
- …providers. + Driver's License - CA Department of Motor Vehicles -REQUIRED ** Preferred Qualifications** + Coursework in medical terminology and/or medical billing. + ... of service and interaction is provided, including accurate and timely claims processing, issue resolution, performance recognition, education and training programs,… more
- Walgreens (Madera, CA)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more