- Ventura County (Ventura, CA)
- …resources management) AND two (2) years' experience handling workers' compensation claims , including experience with claim evaluation, management, or adjustment, ... MB4, MS3, MT3, MT4, MU3, MU4 01 Please describe your workers' compensation claims handling experience, including experience with claim evaluation, management, or… more
- Sedgwick (Sacramento, CA)
- …attends mock trials, focus groups, mediations, settlement conferences, and trials. + Prepares claim processing instructions for use by TPA, prepares and revises ... Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Manager | Staff Attorney | Public Entity Pooling...reviews with TPA, and provides feedback to TPA on claim handling concerns. + Reviews TPA recommendations on government… more
- Sharp HealthCare (San Diego, CA)
- …for operational support to respond to contract informational needs; analyzes contractual claims processing and compensation terms of Primary Care, Specialty, and ... relates to required contractual changes to ensure compliant and timely claims processing and reimbursement.Responsible for generating SCMG Contract Verification… more
- TEKsystems (Los Angeles, CA)
- …experience with HMO/Medicare claims , audits, and denials + Familiarity with claims processing systems (EZCap or similar) + Strong analytical, documentation, ... Job Title: Retro Claims Reviewer Location: West Hills/Canoga Park 91305 Compensation:...or similar) + Collaborate with cross-functional teams to resolve claim issues and process gaps + Document findings, prepare… more
- Sedgwick (West Hills, CA)
- …system documentation.** **Coordinates investigative efforts to ensure thorough and appropriate claim reviews.** **Identifies when claims require external support ... **_caring counts-and so do you._** **We're not just a global leader in claims management; we're a team driven by empathy, expertise, and impact. Right now,… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement. They will process claims correctly following ... claim on to leadership for further review and or appropriate resolution of claim . Incumbent is responsible for daily processing of assigned work queues… more
- Ventura County (Ventura, CA)
- …general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance ... health record (EHR) systems such as Cerner, HURON, and/or Claim Source to follow up on accounts. Medical Billing...more years 02 Describe your experience with billing and processing claims for timely reimbursement and compliance… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …accurate reporting of the service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from ... electronic claim vendor processing , They are to correct...is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to… more
- Molina Healthcare (CA)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Sacramento County (Sacramento, CA)
- …1/29/26 (Final) Under direction, the Workers' Compensation Examiner performs specialized claims service in the administration of the County's self-insured Workers' ... relating to workers' compensation matters + Methods of evaluating workers' compensation claims and computing benefits Ability to + Read, interpret, and apply… more
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