- The County of Los Angeles (Los Angeles, CA)
- …operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors. + ... Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance sheets,… 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, ... training and mentor programs, and assists to provide interview/hiring and audit support when needed. **ESSENTIAL RESPONSIBILITIES** + Supervises the daily operations… more
- Sharp HealthCare (San Diego, CA)
- …investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- Highmark Health (Sacramento, CA)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- Ventura County (Ventura, CA)
- …(III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, ... billing work, incumbents perform program administrative duties to assure that all claims are billed timely. WHAT WE OFFER The County of Ventura offers… more
- Highmark Health (Sacramento, CA)
- …for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into ... Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated… more
- Movn Health (CA)
- …Senior Medical Biller & A/R Specialist to take full ownership of claims processing and accounts receivable recovery. This is a hands-on, senior-level role ... payer systems is essential. Functional Responsibilities + Submit clean claims via EHR to all payers within 24 hours...+ Maintain accurate billing records and correspondence logs for audit -readiness + Support junior billing staff with training and… more
- The County of Los Angeles (Los Angeles, CA)
- …and our communities by providing extraordinary care. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more
- Banner Health (CA)
- …information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper ... to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials...as a basis for development of coding education and audit plans. 6. Maintains a current knowledge in all… more