- Conduent (Los Angeles, CA)
- … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
- Sedgwick (Sacramento, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, Liability **PRIMARY PURPOSE** : To supervise the operation of… more
- Sedgwick (West Hills, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | West Hills, CA Are you...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- Sedgwick (Sacramento, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To supervise a team of… more
- Prime Therapeutics (Rancho Cordova, CA)
- … audit analytics and professional knowledge to identify educational trends and select claims for audit in alignment to department procedures and objectives + ... of audit tools and processes to effectively identify erroneous claims , non-compliant pharmacy practices or potential pharmacy reimbursements + Track audit… more
- TEKsystems (Los Angeles, CA)
- …analyzing benefits, and supporting compliance and auto-adjudication processes. Key Responsibilities + Audit denied provider claims (13/hour) and member claims ... Job Title: Claims Examiner - Contract Role Location: Northridge, CA...Pay: $25/hour Position Overview We are seeking a detail-oriented Claims Examiner for a short-term contract role. This position… more
- Prime Healthcare (Ontario, CA)
- … Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of Claims data, the VP will identify financial ... Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of...Health Plans. The VP of Health Plan Operations and Claims will provide strategic leadership and development of the… more
- WTW (San Francisco, CA)
- …management program design, pharmacy solutions, disability/absence management strategies and claims audit services. Product-based solutions such as our ... pharmacy purchasing coalition round out our broad-based suite of offerings. **Explore an opportunity.** By joining together health management, wellbeing, and I&D we look to bring insights, people and solutions together across multi-dimensions to amplify WTW's… more
- WTW (Irvine, CA)
- …management program design, pharmacy solutions, disability/absence management strategies and claims audit services. Product-based solutions such as our ... pharmacy purchasing coalition round out our broad-based suite of offerings. **Explore an opportunity.** As a Health and Benefits Intern, you will work beside some of the industry's top consultants while you progress toward becoming a thought leader of the… more
- Sedgwick (West Hills, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor… more