- LA Care Health Plan (Los Angeles, CA)
- …Collaborates with internal departments (Member Services, Provider Network Operations, Claims , Utilization Management, Pharmacy, and Quality Management) to ensure the ... of care issues and work collaboratively with multiple departments ( Claims , Provider Network Operations, Utilization Management, Quality Management, Pharmacy) to… more
- Otsuka America Pharmaceutical Inc. (San Francisco, CA)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Sedgwick (San Francisco, CA)
- …services. + Monitors, assists, tracks, and provides approval for all claims that are re-inspected by the Carrier. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** ... 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
- Rady Children's Hospital San Diego (San Diego, CA)
- …service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic claim vendor processing, ... is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to...by payors. Responsible to validate and accurately complete the claims identified with potential new payor plan coverage added… more
- Stanford University (Stanford, CA)
- …established criteria and communicate discrepancies in real time. + Process/assist with claims for dental care and durable medical equipment (DME)/orthopedic brace. + ... NCAA and/or outside secondary insurance for any student-athlete related health insurance claims . + Work collaboratively with the sports medicine clinic (SMC) to help… 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 take the above steps to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be a valid reason for late… more
- Walgreens (San Jose, 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
- Walgreens (Porterville, 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
- Banner Health (CA)
- …activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a ... CORE FUNCTIONS 1. May be assigned to process payments, adjustments, claims , correspondence, refunds, denials, financial/charity applications, and/or payment plans in… more
- Humana (Sacramento, CA)
- …**Required Qualifications** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, ... Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience in a… more