- Cedars-Sinai (CA)
- … claims required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred. **About Us** Cedars-Sinai is ... **Job Description** The Claims Examiner is responsible for accurately and consistently...scanned, EDI, or manual documents for pertinent data on claim for complete and accurate information. + Acquires daily… more
- UCLA Health (Los Angeles, CA)
- …You will be responsible for monthly random and focus audits of all claim processing activities to identify inaccurate claims adjudication. This will involve ... on a key role within a world-class, award-winning health system . Ensure the efficient delivery of award-winning patient care....proficiency with Microsoft Word and Excel * Knowledge of claims adjudication systems (eg, EPIC-Tapestry, QNXT, IDX… more
- ADP (San Dimas, CA)
- …state-of--the art predictive modeling, and metrics, data analytic tools and HRIS and claims systems . + Requires comprehensive knowledge of CA and western region ... ADP is hiring a ** Claims Lead Examiner** . **_RESPONSIBILITIES:_** + Assist ...department and company goals. + Monitor and ensure qualitative claim handling through TPA and other vendor partners. +… more
- Guidehouse (San Marcos, CA)
- …Reconciliation **Duties and Responsibilities** + Performs daily download and reconciliation of claims from patient accounting system to electronic billing ... system . + Transmits or releases claims at a minimum daily. + Works all assigned claims daily by resolving edits, validating claim , or placing on… more
- Providence (CA)
- …feedback and recommendations, evaluations, litigation trends, department policies and procedures, system -wide claims and litigation processes, and appropriate ... **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many...for each matter:** + Develop and document for each claim or lawsuit a plan of action for resolution… more
- Sedgwick (Sacramento, CA)
- …skills and knowledge, the Associate will review documents and other third-party administrator's claims system to make recommendations when needed to staff that ... identifying trends in audit exceptions. + Reviews and updates notes/diaries in claims management system as instructed. + Coordinates jurisdictional training on… more
- Robert Half Office Team (Ontario, CA)
- Description We are looking for a detail oriented Entry-level Claims Representative to join our clients' team in Ontario, California. In this role, you will provide ... critical support in managing claims -related tasks, ensuring accuracy and efficiency in processing, reconciling,...and letters to providers. * Print and send out claim requirement letters for Covered California members. * Forward… more
- Kemper (Cerritos, CA)
- …with conflict in an effective manner + Proficient in MS Office + Experience with Guidewire claims system is a plus + This is a hybrid position reporting to the ... negotiation skills? Kemper is looking for experienced Represented Bodily Injury Claims Adjusters for our growing teams! This specialized position focuses solely… more
- NTT DATA North America (Merced, CA)
- …+ Minimum of 5 years (or a Master's degree and three years) of claims systems configuration experience which included some experience related to training staff. ... USA. **Job Overview:** The Application Analyst III - Core Systems is the advanced working level position in the...working level position in the Application Analyst - Core Systems series and is distinguished from the higher, expert… more
- NTT DATA North America (Ontario, CA)
- …relations, legal, IT, compliance teams -Support internal initiatives related to claims systems / operational improvements **Required Qualifications and skills:** ... **Senior Claims Examiner (Xcelys System )** **NTT DATA...adjudication experience -1+ year experience in Xcelys or equivalent claims adjudication systems -1 year of expertise… more