- Evolent (Sacramento, CA)
- …with Group Health track **(Preferred)** + Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or management ... clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for...require that all employees have the following technical capability at their home : High speed internet over… more
- Humana (Sacramento, CA)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and ... Policies and Claims Payment Policies + CAS claims processing experience + Experience in data...experience + Experience in data analysis and trend monitoring **Work- At - Home Requirements** To ensure Home … more
- Humana (Sacramento, CA)
- …Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing , and customer service, each essential to ... knowledge of core functional areas (care coordination, quality, billing, claims , and customer service). + Collaborate with each Insurance...Home /Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and… more
- LA Care Health Plan (Los Angeles, CA)
- …incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member ... we make sure our members get the right care at the right place at the right...predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other… more
- CenterWell (Sacramento, CA)
- …scheduling, pre-appointment preparation, follow up tasks for medication reconciliation/education. + Processing of select medication claim updates (lists) as ... + Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan...pay for full time (40 hours per week) employment at the time of posting. The pay range may… more
- Providence (Anaheim, CA)
- …of Experience in health care or pharmacy billing, collections or medical claims processing . **Preferred qualifications:** + Bachelor's Degree in Business, ... are not simply valued - they're invaluable. Join our team at St. Joseph Health System Home Care Services and thrive in our culture of patient-focused,… more
- Humana (Sacramento, CA)
- …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... the self-provided internet service of Home or Hybrid Home /Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an… more
- Ventura County (Ventura, CA)
- …an initial 5% merit increase within the pay range upon completion of at least 1,040 hours (approximately 6 months) assuming work meets satisfactory standards. ... hours or 5 years of service; vacation accruals increase at 5, 11, 12, 13, 14, 15 and 20...The County includes 42 miles of coastline which is home to the fol-lowing cities and points of interest:… more
- LA Care Health Plan (Los Angeles, CA)
- …plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: LA Care's mission is to ... providing clinical review and authorization for alternate levels of care, home health, durable medical equipment, and other discharge needs. Provides support… more
- City and County of San Francisco (San Francisco, CA)
- …the City and County of San Francisco have to offer. Human Services Agency (HSA) At the San Francisco Human Services Agency, we believe in a San Francisco where ... child and adult protective services, health care coverage, affordable childcare, and in- home services for older adults and persons with disabilities, our team lends… more