- University of Southern California (Alhambra, CA)
- … Specialist " analyze, investigate, mitigate, and resolve all coding-related ' claims denials' and ' claims rejections,' specific to ICD-10-CM, ICD-10-PCS, ... which might prevent or delay payment of a particular claim or group of claims . Prepares appeals...guidance and training to other HIM Coding Denials Management Specialist , and will assist with escalated issues. Essential Duties:… more
- Morley (CA)
- …case details? If so, this role could be a perfect fit for you! As a Legal Claims Analyst at Morley, you'll play a key role in managing small automotive claims ... to support the client's defense strategies, including lemon law claims + Serve as the "Person Most Knowledgeable" (PMK)...Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 5 am… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and adjudication ... of complex healthcare claims . This position requires expert knowledge of ...work experience will be considered. + Certified Medical Reimbursement Specialist (CMRS), or similar certification is preferred. + CPC… more
- Sedgwick (Sacramento, CA)
- …of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for ... Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims… more
- Sedgwick (West Hills, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance LTD Case Specialist **PRIMARY PURPOSE** **:** To analyze claims and determine benefits due ... Manager, or Project Manager. + Negotiates settlement of appropriate claims within designated authority level. + Makes claim... claims within designated authority level. + Makes claim payments and revisions to benefit amounts. + Communicates… more
- WestCare Foundation (Fresno, CA)
- …DMC-ODS, Enhanced Care Management (ECM), and Community Supports. This position ensures claims are submitted accurately and timely directly to insurance carriers and ... Plans (MCPs) in accordance with all DHCS, payer, and organizational guidelines. The specialist works closely with fiscal, clinical, and data teams to ensure service… more
- Scripps Health (San Diego, CA)
- …who thrives in a fast-paced environment and has a passion for insurance and medical claims . As a Patient Account Specialist , you will be responsible for the ... one of the most respected healthcare organizations nationwide. As a Patient Account Specialist , you will be supporting the Billing Services department at our 4S… more
- The County of Los Angeles (Los Angeles, CA)
- Program Specialist III, CEO - Workers' Compensation Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5097980) Apply Program Specialist III, ... The Opportunity We are pursuing qualified candidates to fill Program Specialist III, CEO positions within the Chief Executive Office's Workers' Compensation… more
- Stanford Health Care (Palo Alto, CA)
- …Health Care job.** **A Brief Overview** The Single Path Coding (SPC) Specialist -Level 2 is an advanced coder position responsible for reviewing clinical ... American Medical Association (AMA) CPT Assistant. The SPC Coding Specialist II serves as a subject matter expert in...modifiers as applicable for both the hospital and professional claim + Validate and process any medical necessity edits… more
- Molina Healthcare (CA)
- …and prepares written response to incoming provider reconsideration requests related to claims payment, requests for claim adjustments, and/or requests from ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more