- Humana (Sacramento, CA)
- …to make an impact** **Required Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience in conducting thorough root ... first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied… more
- Robert Half Office Team (Long Beach, CA)
- …collaboratively with billing departments and other staff to ensure accurate coding, claims processing , and compliance with Medi-Cal regulations. * Maintain ... and application procedures. + Familiarity with healthcare billing systems and insurance claims is a plus. + Exceptional attention to detail and the ability… more
- Sharp HealthCare (San Diego, CA)
- …non-clinical appeals and grievances. **Required Qualifications** + 3 years' experience in claims , utilization review, appeals or member services in a managed care ... requests for assistance.Provides feedback to Customer Service, Enrollment, Provider Relations, Claims Research, and Health Services on issues and trends identified… more
- Executive Office for US Attorneys and the Office of the US… (San Francisco, CA)
- …Perform full range of collection activities ensuring compliance with the Federal Claims Collection Standards. Assignments typically relate to such areas as the ... collection of claims by various agencies against debtors arising from criminal...of specialized experience may include the following: examining and processing a variety of legal documents; conducting research, analysis… more
- UIC Government Services and the Bowhead Family of Companies (San Diego, CA)
- …required. + Extensive computer/PC knowledge required including; spreadsheet software, word processing software and knowledge of MS Office Suite. + Must be ... 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
- International Paper (Anaheim, CA)
- …accuracy of shared files and databases. + Ensures timely and accurate processing of human resource-related forms; researches and furnishes employee information to ... to FMLA, disabilities, and return to work. + Processes all unemployment-related claims ; participates in any appeal hearings or other activities related to… 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 ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as… more
- The County of Los Angeles (Los Angeles, CA)
- …of the court. + Identifying and cataloguing birds, mammals and fossils. + Processing writs and judgments; filing legal documents; documenting and entering results of ... to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be...filtered as spam/junk/clutter mail.Los Angeles County will not consider claims of not viewing or receiving notification to be… more
- Humana (Sacramento, CA)
- …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Sedgwick (San Diego, CA)
- …directly with auto repair facilities to determinate supplemental repair processing and provides a supplemental estimate. **ADDITIONAL FUNCTIONS and ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more