- Walgreens (Aliso Viejo, CA)
- …pharmacy errors and the Continuous Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. + Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational… more
- Grant Thornton (Newport Beach, CA)
- …related to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing , billing, and reimbursement, with a focus on ... enhancing financial performance and operational efficiency. + Strong understanding of key healthcare regulations and initiatives, and the ability to evaluate organizational compliance with regulatory bodies such as the Office of Inspector General (OIG) and the… more
- Ventura County (Ventura, CA)
- …of intricate federal, state and local rules to ensure that expenditures, claims , fiscal protocols, and all supporting documentation are appropriate and will ... representative at various local and state work groups, committees and task forces, processing issues through both fiscal and policy lenses. + Reviews and assesses… more
- Humana (Sacramento, CA)
- …2 years of Humana Experience + Knowledge of Humana Medical and Pharmacy Claims Processing Systems + Experience with data query/data programming applications (ie ... SQL, Python) + Knowledge of data visualization tools (ie Power BI, QlikView, Tableau) **Additional Information** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and… more
- Cognizant (Sacramento, CA)
- …not limited to Robotic Process Automation (RPA) team, Process Excellence team, Claims team, Information Technology, and Human Resources to effectively develop and ... degree in business management preferred * 2+ years in enrollment processing or reconciliation preferred * Knowledge of Healthcare insurance regulations, Medicaid… more
- Edwards Lifesciences (Irvine, CA)
- …data governance activities, working with data stewards to ensure high-quality data processing and management. + Assist in identifying and integrating new data ... setting. + Strong proficiency in real world data (eg, Optum, IQVIA Claims , CMS, AcuityMD, Definitive Healthcare) and ability to communicate complex insights… more
- Humana (Sacramento, CA)
- …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... corporate environment and understanding of business operations + Bilingual in Spanish **Additional Information** **Work at Home Requirements** * At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL… more
- University of Southern California (Arcadia, CA)
- …and Medicare, Medi-Cal and indigent service programs and requirements for timely processing of claims . + Offering assistance promptly, cordially, and completely ... + Patient care is of the utmost priority in all aspects of registration. Must be comfortable with sick patients and able to summon medical assistance when needed. Must be BLS certified each year. + Patient valuables are to be closely monitored by all Patient… more
- Crash Champions (Signal Hill, CA)
- …+ Educating customers about the collision repair process including insurance claims information, processing , and payment procedures. **Qualifications** To be ... selected, a candidate must embody professionalism and display the skills consistent with the Crash Champions culture and brand, including but not limited to: + Arrive every day, on time, ready to learn + Commit to 7-9 months for program completion + Maintain a… more
- Robert Half Accountemps (Van Nuys, CA)
- …a critical part in maximizing hospital revenue by managing insurance denials, processing appeals, and handling collections related to HMO/PPO insurance claims . ... A strong understanding of UB-04 billing practices is required. Key Responsibilities: + Review and analyze insurance denials and identify appropriate action steps for appeal or resubmission. + Prepare and submit timely, thorough appeals using clinical and… more
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