- Providence (CA)
- …update and create Coding Policies and associated edit configurations within the PHP claims editing system. In addition, the Coding Policy Analyst will be responsible ... specialty societies, and assists with implementation of such changes to the claims adjudication and editing software. **Providence Health Plan** caregivers are not… more
- CVS Health (Sacramento, CA)
- …Senior Claim Benefit Specialist reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. They will act as ... customer service inquiries and problems. **Key Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication authority or… more
- Robert Half Accountemps (San Diego, CA)
- …full cycle of medical billing processes, ensuring timely and accurate submission of claims for Medicare and Medicaid programs. + Review claims and documentation ... documentation. + Prepare billing activity reports and provide insights to management to support financial planning and decision-making. Requirements + Associate's… more
- Zurich NA (Irvine, CA)
- …+ Work to have a timely resolution to matters by collaborating with the claims adjuster, developing a case strategy and escalating issues as appropriate + Ensure ... state and federal laws and regulations + Protect Zurich's reputation by keeping claims information confidential Basic Qualifications: + Juris Doctor and 5 or more… more
- Sedgwick (Los Angeles, CA)
- …IDEAL CANDIDATE?** If you have a strong background in handling cargo claims , hull and machinery, yacht damage assessments, or investigating marine equipment ... not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the… more
- CVS Health (Sacramento, CA)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …policy and government affairs activities, particularly PhRMA. Contribute to the management of the federal political action committee and the grassroots political ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- UCLA Health (Los Angeles, CA)
- …This position plays a critical role in ensuring timely resolution of outstanding claims and contributes to the overall financial success of the organization. In this ... benefits, and resolve reimbursement issues + Make financial adjustments and rebill claims as needed, ensuring compliance with contract terms and payer policies +… more
- Zurich NA (Gold River, CA)
- …Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 12 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …transfer, validation support, process monitoring, troubleshooting, and lifecycle management activities conducted by external partners. + **Key Responsibilities:** ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more