- Highmark Health (Sacramento, CA)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES** +… more
- Allied Universal (Oakland, CA)
- …and services for all leased or owned University properties. + Conduct claims evaluations, accident inquiries, and evaluate risk management claims information ... broker, insurance carrier, and employee to monitor and resolve claims . + Works alongside selected broker within the Risk...the system. + Provide reports and assist with identifying claim trends within the Risk Management Program. + Coordinates… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …Accurately document benefit verification results in pharmacy systems. . Troubleshoot rejected claims and perform necessary claim adjustments. . Assist in ... of prior authorization routing and third-party review processes. . Experience with claim troubleshooting and payer override procedures. . Strong verbal and written… more
- CDM Smith (Carlsbad, CA)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Identify contractual requirements to maintain and prosecute claims , and assist project team in managing to those...above. This pay range is a good faith estimate representative of all experience levels for this position based… more
- Allied Universal (San Diego, CA)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …can be frustrating and we are here to help. The Customer Service Representative 's primary role is to support relationships with members, providers and health plans. ... processing Researching and responding to provider calls regarding authorization or claim payment status Any other questions they may have Skills Required:… more
- Medtronic (Los Angeles, CA)
- …connected, compassionate world. **A Day in the Life** The Principal Insurance and Claims Management role is a newly created expert and highly specialized position ... at all levels to gather information for insurance placement, facilitates claims resolution between internal and external stakeholders, provides transparency and… more
- Ross Stores, Inc. (Dublin, CA)
- …of the Employment Law team primarily assessing, handling, and managing employment claims including defending Ross in agency hearings and in arbitrations\. This ... primarily working on optimal litigation results \(agency, individual, and representative actions\) with the potential for future work on...other employment law team members on the handling of claims and other tasks as assigned\. The base salary… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... respect. DUTIES/RESPONSIBILITIES: + Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... DUTIES/RESPONSIBILITIES: * Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate… more
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