- Sedgwick (Sacramento, CA)
- …payable for risk pool clients, including coding checks, verifying signatures, processing checks, filing, and related journal entries. + Interfaces with clients ... the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate… more
- Oura (San Francisco, CA)
- …this role will be responsible for advising on regulatory risk, marketing claims , product labeling, corporate compliance initiatives, and will oversee the privacy ... tracking, AI-driven diagnostics, real-world data applications, and health and wellness claims . + Provide legal and regulatory oversight for clinical studies and… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... fostering teamwork. + Experience with spreadsheets, data reporting, and word processing applications. **Preferred Qualifications** + Other Course work or prior… more
- LA Care Health Plan (Los Angeles, CA)
- …Advanced understanding of managed care operations (including but not limited to, claims processing , population health, appeals and grievances, etc.) and the ... of major factors, root causes, etc. that impact member access to care, claims payments, etc.; and assessment and roll-out of key measures to facilitate improvement,… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …provider offices), answering the phone (including all provider calls regarding authorization processing , claims related phone calls, and any other calls received ... tasks. This includes, but is not limited to, initial authorization processing , (data entry, eligibility verification, benefits verification, and requesting required… more
- Humana (Sacramento, CA)
- …make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,… more
- Adecco US, Inc. (Fountain Valley, CA)
- …of internal and Korean financial statements for Parts Accounting. . Establish procedures for processing warranty claims ; monitor such claims as received and ... and participate in month-end closing activities including SAP system transaction processing , preparation of internal and external financial schedules. . Ensure… more
- LA Care Health Plan (Los Angeles, CA)
- …Compliance Reports. In addition, the position performs data entry and processing of referrals/authorizations in the system, authorizes request consistent with auto ... as assigned. Duties Functional Elements: Technical Support to UM Specialist: Processing of time sensitive authorization and pre-certification requests to meet… more
- The County of Los Angeles (Los Angeles, CA)
- …typically report to a higher-level manager and are responsible for processing and maintaining credentialing documentation for review by the credentialing review ... education, employment history, licensure, professional references, hospital affiliations and liability claims history by performing on-line queries from a variety of… more