- Sedgwick (Roseville, CA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim .... Professional certification as applicable to line of business preferred . **Experience** Five (5) years of claims … more
- Sedgwick (Sacramento, CA)
- …of education and experience required to include two (2) years of claims supervisor experience. **SUPERVISORY RESPONSIBILITIES** + Performs other duties as ... claim status; and provides written resumes on specific claims as requested by client. + Maintains frequent diaries...required. Professional certifications as applicable to line of business preferred . **Experience** Six (6) years of claims … more
- ICW Group (San Diego, CA)
- …Workers' Compensation Claims Administration (WCCA) and Workers' Compensation Claim Professional (WCCP) certifications preferred . _All other jurisdictions:_ ... and providing benefits as prescribed by law. + Ensures claim files are properly documented and claims ...(GED) required. Bachelor's degree from four-year college or university preferred . Minimum 1 year of insurance or claims… more
- Unilever (El Segundo, CA)
- …is not intended to limit or in any way modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision. Ability to ... out-of-the-box thinker to join our R&D Scientific Affairs team as the Claims Substantiation Lead (Associate Principal Scientist) Reporting to the Sr. Director,… more
- TEKsystems (Fresno, CA)
- MUST LIVE WITHIN A 90 MILE RADIUS OF FRESNO, CA. Description The Claims Examiner I reports to the Supervisor of Claims . Claims Examiner I is responsible ... three (3) years year of experience as a Health Claims Examiner or comparable industry experience preferred ....Summary Plan Descriptions (SPD) for the purpose of accurate claim adjudication and/or benefit determination * Basic knowledge of… more
- Cardinal Health (Fresno, CA)
- …from prior authorization through billing and collections._ The Revenue Cycle Supervisor is responsible for generating revenue by monitoring and pursuing payment ... for all unpaid and delinquent denied claims . They also act as a liaison between the...the LCD/NCD requirements. + Identify trends that inhibit timely claim submission for all centers. + Work closely with… more
- Highmark Health (Sacramento, CA)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... and performance standards are consistently met. Responsibilities include: provides supervisor direction, scheduling and support for customer service representatives… more
- Dignity Health (Rancho Cordova, CA)
- **Responsibilities** The Enrollment Supervisor reports to the Director of Claims Management. In this role, they oversee the eligibility department and are ... EDI files are processed and loaded accurately and timely. The Enrollment Supervisor assists with developing and maintaining the EDI maps to ensure compliance… more
- Walgreens (Brea, CA)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Cedars-Sinai (CA)
- …arise. **Department specific responsibilities include:** Analyzes, trends, reports out, and resolves pended claims in PB Claim Edit WQs and PB Payer Rejection ... clean claim submissions and timely reimbursement. Completes special PB claims related projects as assigned. These projects could include trending issues to… more