- Highmark Health (Sacramento, CA)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly… more
- Herbalife (Torrance, CA)
- …and MX. The position's accountabilities include reviewing scientific literature for claim substantiation based on the totality of evidence, supporting Herbalife ... reports to support scientific substantiation of product safety and efficacy claims under minimum guidance. * Develops product efficacy and safety documentation… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance ... operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors.… more
- Cardinal Health (Sacramento, CA)
- …reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...and submitting claims to payers, correcting rejected claims , following up on unpaid and denied claims… more
- LA Care Health Plan (Los Angeles, CA)
- …knowledge of claims coding and medical terminology. Solid understanding of standard claims processing systems and claims data analysis. Strong project ... Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition… more
- UCLA Health (Los Angeles, CA)
- …Microsoft Excel + Knowledge of Tableau Reporting dashboards + Understanding of Medicare/Medi-Cal claims processing guidelines + Experience with EPIC EHR, Cirius ... government regulations, reimbursement issues, etc. + Analyze hospital billing claims within the EHR and claim scrubber system + Resolve claim errors, edits,… more
- Robert Half Accountemps (Los Angeles, CA)
- …and manually, as needed, and uses all technology available to produce clean claims . * Interprets claims processing reports and applies information ... information as necessary in order to produce a clean claim . * Meets or exceeds productivity standards in the...ability to analyze coding to assure proper billing of claim . * Participates in a variety of hospital educational… more
- Cardinal Health (Sacramento, CA)
- … + Preparing, reviewing and billing claims via electronic software and paper claim processing + Insurance claims follow up regarding discrepancies in ... administration, customer and vendor pricing, rebates, billing (including drop-ships), processing charge backs and vendor invoices, developing and negotiating… more
- Cognizant (Sacramento, CA)
- …will make an impact by configuring and maintaining QNXT systems to ensure accurate claims processing and compliance with client requirements. You will be a ... + Perform **back-end queries** and validate configuration setups to ensure accurate claim processing . + Advise clients on **configuration decisions** in… more
- Sedgwick (Pasadena, CA)
- … claim files. + Processes packets. + Conducts computer data entry and processing ; documents claim files in the system correctly. + Prepares spreadsheets 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