- Molina Healthcare (Long Beach, CA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
- Robert Half Legal (San Francisco, CA)
- …their insureds. This is a NON-LITIGATION position. If you are currently litigating insurance claims and want to shift away from litigation to a hybrid remote firm, ... their insureds * Investigate and research complex matters involving detail-oriented liability claims * Analyze complex insurance contracts and policy forms and apply… more
- Zurich NA (Los Angeles, CA)
- …challenging and varied caseload. Responsibilities will include working directly with claims professionals providing legal analysis and advice, preparing and filing ... Lexis or Westlaw + Knowledge of the insurance industry, claims and the insurance defense litigation legal environment +...Lexis or Westlaw + Knowledge of the insurance industry, claims and the insurance defense litigation legal environment +… more
- Robert Half Accountemps (Lynwood, CA)
- …opportunities may be available. Key Responsibilities: Submit and process medical claims accurately to Medi-Cal, commercial insurance, government payers, and other ... Manage denials and appeals, researching root causes, documenting issues, and resubmitting claims as needed. Collaborate with payers and providers to resolve complex… more
- Elevance Health (Walnut Creek, CA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... DUTIES/RESPONSIBILITIES: * Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate… 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, ... problems. Provides research and technical support need to address complex claims and inquiries and/or when systems problems occur. Provides direction for… more
- Travelers Insurance Company (Walnut Creek, CA)
- …Compensation Claim Professional Trainee, you will handle all aspects of a workers compensation claims . In this role, you will learn how to help our customers and ... needed for quality claim handling including investigating, evaluating, negotiating, and resolving claims on losses of lesser value and complexity and provide claim… more
- Sedgwick (Sacramento, CA)
- …the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- The County of Los Angeles (Los Angeles, CA)
- …applicant's responsibility to take steps to view correspondence, and we will not consider claims of missing notices to be a valid reason for re-scheduling an exam ... to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be...steps to view correspondence, and we will not consider claims of missing notices to be a valid reason… more