- Public Consulting Group (Sacramento, CA)
- …through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist ... and medical record reviews that will include discussion with internal management to ensure understanding of results. **Summary of Functions** The Contract… more
- LA Care Health Plan (Los Angeles, CA)
- …Advanced understanding of managed care operations (including but not limited to, claims processing; provider contracting, network and data management ; complex ... to claims processing. Strong communication, analytical, organizational, and time management skills. Able to manage projects and initiatives end-to-end. Able to… more
- Cardinal Health (Sacramento, CA)
- …their distribution channels, ensuring broader access to innovative therapies. + ** Claims Adjudication:** Oversee the claims adjudication process, ensuring timely ... and accurate processing of ATSP claims for CGT treatments. + **Compliance:** Ensure all contracting...with different health care stakeholder types) + Strong time management to enable prompt follow up to any payor… more
- Humana (Sacramento, CA)
- …+ Provider contract interpretation experience + Previous account management or project management + Knowledge with medical claims + Ability to accommodate a ... provider relations to support customer service activities through data integrity management needed for service operations. The Network Operations Coordinator 4… more
- Rexel USA (Anaheim, CA)
- …possible + Coordinate with vendors, customers and sales teams on pricing, order placement, claims and returned goods, and account management to ensure we are ... abilities needed to perform the job. Please note that management retains the right to assign or reassign duties...**What You'll Need** + 7+ years of quotation, project management , or customer service experience + Experience in electrical… more
- Humana (Sacramento, CA)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates… more
- Cardinal Health (Sacramento, CA)
- …is responsible for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following up on unpaid ... insurance providers + Researching and appealing denied and rejected claims + Preparing, reviewing, and transmitting claims ...experience as a Medical Biller or within Revenue Cycle Management preferred + Strong knowledge of Microsoft Excel +… more
- Kemper (San Bernardino, CA)
- …III is responsible for the investigation of complex, large loss, and multi-injury claims that may contain elements of fraud or claims otherwise deemed ... multi-feature and attorney represented losses. Basic functions include: Investigation of claims , analysis and development of facts and evidence, and conducting… more
- Mendocino County Sheriff's Office (Ukiah, CA)
- …dependents within Mendocino County, offering counseling, guidance, and advocacy throughout the claims process to help veterans and their families access the benefits ... gathers, and evaluates records, documentation, and other evidence to support claims for benefits; assists veterans and/or their dependents in obtaining required… more
- EMCOR Group (Irvine, CA)
- …investigations and root cause analyses; partner with Operations, Corporate Safety, HR, and Claims on corrective actions and case management . * Data Analytics & ... speak confidently to groups. * Proficient in Microsoft Office; experience with safety management software preferred. * Ability to walk job sites, climb ladders, and… more