- Travelers Insurance Company (San Diego, CA)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... responsible for product quality and performance for a specific team of claim professionals. Provide guidance and direction to direct reports through a continuous… more
- CTG (CA)
- …on Behavioral Health and Ambulatory services. + Design, build, and maintain Epic HB Claims configuration, including claim edit rules, claim definition rules, ... system environments preferred. + Familiarity with third-party billing systems , clearinghouses, or RCM platforms preferred. + Experience with Epic reporting… more
- Illumination Foundation (Santa Ana, CA)
- …up on outstanding account receivables + Review any rejected or denied claims and conduct proper follow up procedures (Escalations/Appeals/ Claim corrections) + ... EOB's and Remittance Advice + Posting payment accurately to claims and continuing with the claim close...Prior experience work in Electronic Billing Platforms and EHR systems + Prior experience working with claims … more
- Lincoln Financial (Sacramento, CA)
- …and applying knowledge. You will analyze and manage a caseload of appeals claims . You will review, investigate, and make claim determinations regarding coverage, ... to Claims management & teams regarding products, claims processes, regulations, and applicable systems for...& obtaining a wide range of complex information. Apply claim policies & procedures and engages intervention of internal/external… more
- Prime Healthcare (Ontario, CA)
- Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 ... annually. It is one of the nation's leading health systems with nearly 57,000 employees and physicians. Eighteen of...Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of… more
- Cognizant (Sacramento, CA)
- …Plan Document. **Role Responsibilities** + Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB, ... business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical**...and criteria has been met. + Responsible for reviewing claim and line item edits and warning messages for… more
- CTG (CA)
- …+ ** System Configuration & Build:** Configure and maintain Epic PB Claims functionality, including claim edit rules, charge review workqueues, and ... Behavioral Health and Ambulatory billing requirements across multiple states. + ** Claims Management & Troubleshooting:** Monitor claim generation for accuracy… more
- Cognizant (Sacramento, CA)
- …regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing ... manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment...information, and updating information to claim file about claims … more
- NTT DATA North America (Ontario, CA)
- …with cross-functional teams, such as provider relations, legal, and IT, to address claims system or operational improvements. + Prepare and deliver production, ... Act as the first point of escalation for complex claim issues and provide expert assistance. + Conduct regular...reports to management. + Support internal initiatives related to claims system improvements and operational changes. **Required… more
- Avispa Technology (Los Angeles, CA)
- …The successful candidate will be responsible for the initial data entry of received paper claims into the claims processing system , in compliance with all ... Claims Intake Coordinator - Healthcare 3055917 * Hourly...95% accuracy rate. * Identify provider/vendor and/or eligibility maintenance claim work queues for internal department review as needed.… more