- NTT DATA North America (Ontario, CA)
- …provider relations, legal, IT, compliance teams + Support internal initiatives related to claims systems / operational improvements **Success Measures / KPIs** + ... on claims workflows and be a key contributor to system enhancements, audits, and process optimizations. **Responsibilities** Adjudication & Review + Process… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed ... care service organization. This role involves auditing claims , identifying errors, and implementing corrective actions to improve overall claims accuracy and… more
- Molina Healthcare (Long Beach, CA)
- …issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems . ... and investigation/research experience. Outcome focused and knowledge of multiple systems . 1+ years of claims research and/or...knowledge of multiple systems . 1+ years of claims research and/or issue resolution or analysis of reimbursement… more
- ICW Group (Pleasanton, CA)
- …and adopting the industry's best practices. + Ensures accuracy of data in claims system for compliance with applicable regulatory reporting. + Provides knowledge ... to be here! **PURPOSE OF THE JOB** The Senior Claims Examiner handles moderate to complex claims ...urgency, understands insurance coverage concepts, and navigates the legal system with the support of counsel to drive strategic… more
- NTT DATA North America (Ontario, CA)
- …relations, legal, IT, compliance teams + Support internal initiatives related to claims systems / operational improvements **Required Skills/Experience** + 5+ ... on claims workflows and be a key contributor to system enhancements, audits, and process optimizations. **Role Responsibilities:** 1. Adjudication & Review… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is ... responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans… more
- NTT DATA North America (CA)
- …relations, legal, IT, compliance teams + Support internal initiatives related to claims systems / operational improvements Required Experience + 5+ years ... NTT DATA Services is currently seeking Xcelys Medical Claims Examiners to join our team remotely for...claims workflows and be a key contributor to system enhancements, audits, and process optimizations. Key Duties &… more
- Philadelphia Insurance Companies (Roseville, CA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Supervisor II - Commercial Auto - BI to join our team. Summary: + Supervises claims ... technical support staff to manage the day-to-day handling and settlement of claims , the processing and tracking of documents, making payments, tracking trends and… more
- Elevance Health (Los Angeles, CA)
- **Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering collaboration ... within a commutable distance from an office._ The **Director II, Digital Claims Operations** oversees a combined digital and operations unit(s); executes strategies… more
- Sedgwick (El Dorado Hills, CA)
- …Dorado Hills office. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE:** + Sets up and enters new claims into claims management system . + Inputs and reviews ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Assistant - El Dorado Hills, CA On-Site Are...notes/diaries in claims management system as instructed. + Processes payments. + Processes mail;… more