- Elevance Health (Walnut Creek, CA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Sedgwick (Sacramento, CA)
- …of accounting department or special projects as assigned by the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims ... 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
- Zurich NA (San Francisco, CA)
- …role will be filled at either the Senior or AVP Level. The hiring manager will determine the appropriate level based upon the selected applicant's experience and ... and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft… more
- Evolent (Sacramento, CA)
- …to find the most valuable defects. The IQA reports to a associate director or a manager . One or many IQAs may be engaged in any testing effort **What You Will Be ... risks and issues in coordination with the lead / manager for status reporting + Responsible to enforce department...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Walgreens (Berkeley, CA)
- …Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Walgreens (San Bruno, CA)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …subject to renewal on 11/28/2025.** JOB SUMMARY: Under the direction of the Manager Professional Billing & Coding, the Billing & Collections Representative II (BCII) ... not limited to; Commercial, Medi-Cal and Managed Care professional claims . This position is responsible checking status of unpaid...remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool… more
- Sharp HealthCare (San Diego, CA)
- …oversees the health care needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its' Chief Medical Officer. **Required ... with medical management such as provider relations, member services, benefits and claims management, IT management, etc. + Plans, organizes, and directs the… more
- Zurich NA (Gold River, CA)
- …talent at any Zurich office location. We may, at the sole discretion of the Hiring Manager , be open to hiring remote talent This role will be filled at either the ... Liability Underwriter or VP, Construction Professional Liability Underwriter. The hiring manager will determine the appropriate level based upon the selected… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …is subject to renewal on 09/01/2025.** JOB SUMMARY: Under the direction of the Manager , Professional Billing & Coding, the Billing & Collections Rep I is responsible ... incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic...remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool… more