- Cedars-Sinai (CA)
- …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... Dispute Request (PDR) fulfillment process from the point of claim review through letter processing and records...required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred.… more
- Stanford Health Care (Palo Alto, CA)
- …procedures and the applicable service agreement. Review reserves, settlement activity, and claims costs. Participate in periodic claim reviews and provide ... **A Brief Overview** Under the direction of the Director, Claims & Litigation Strategy, the Claims Manager...to support loss prevention. + Ensure timely and accurate processing of all claim invoices. **Education Qualifications**… more
- Sedgwick (Roseville, CA)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- WelbeHealth (Los Angeles, CA)
- …corrections + Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and configuration change ... detailed documentation of audit findings which include decision methodology, system or processing errors, and monetary discrepancies + Move claims free of… more
- Highmark Health (Sacramento, CA)
- …the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special ... resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a...accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the… more
- TEKsystems (Santa Barbara, CA)
- …claims specialist with expertise in D-SNP (Dual Eligible Special Needs Plan) claims processing . Skilled in researching, correcting, and resolving pended ... CPT, and HCFA codes. + Review, price, and release claims for assigned claim types (paper and...adherence. + Maintain daily activity logs and assist with claims processing . + Perform additional duties and… more
- Robert Half Office Team (Oakland, CA)
- …customer service to all stakeholders. * Perform additional duties as assigned to support claims processing activities. If you are interested in this role please ... systems, including ICD-10, CPT, and HCPCS. * Minimum of 3 years of claims processing experience in a Medicare/Medi-Cal environment. * Proficiency in computer… more
- Sedgwick (Sacramento, CA)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... distance to Sedgwick Office **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- Sedgwick (Brea, CA)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- Sedgwick (Sacramento, CA)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more