- Dignity Health (Bakersfield, CA)
- … discrepancies for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), ... accurate records for audit purposes. - Collaborate with internal departments, including claims processing , UM, compliance, and provider relations, to develop and… more
- Highmark Health (Sacramento, CA)
- …**Required** + 1 year of related experience **Preferred** + 1 year of claims processing experience + Inquiry resolution system, OCWA, Oscar, Outlook experience ... guidelines. + Knowledge of operating systems specific to claim processing . + Ability to review claims and...to claim processing . + Ability to review claims and analyze critical data. + Reading benefits, investigating… more
- Molina Healthcare (Long Beach, CA)
- …**Required Education** High School or GED **Required Experience** 3-5 years claims processing required **Preferred Education** Bachelor's Degree or equivalent ... combination of education and experience **Preferred Experience** 5-7 years claims processing preferred To all current Molina employees: If you are interested in… more
- Cognizant (Sacramento, CA)
- …School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge of ... payment and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review/quality assurance procedures + Must be… more
- TEKsystems (Fresno, CA)
- …their growing team. This role is ideal for someone with a strong background in claims processing , attention to detail, and a commitment to quality assurance. The ... Office and 10-key data entry (40 WPM). + Knowledge of ERISA claims processing guidelines. Preferred Skills + Basic medical terminology knowledge. + Strong… more
- Centene Corporation (Sacramento, CA)
- …preferably with State or Federal managed care programs required. + Understanding of claims processing rules for professional and facility claims , managed ... PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective claims… more
- Providence (CA)
- …or legal handling of claims issues. + 5 years Relevant general claims processing or management experience or an equivalent combination of direct legal ... **Description** ** Claims Manager** **_Remote. Candidates residing in AK, WA,...OR, CA or TX are encouraged to apply._** The Claims Manager is responsible for day-to-day oversight of general… more
- Providence (CA)
- … issues. + 7 years of relevant general and professional liability claims processing or management experience **Preferred qualifications for this position ... empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, general,… more
- Molina Healthcare (Long Beach, CA)
- …is involved in member enrollment, provider information management, benefits configuration and/or claims processing . + Responds to incoming calls from providers ... **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating,… more
- Golden State Foods (Irvine, CA)
- …and oversees claims handling procedures and program enhancements to streamline claims processing and mitigate loss + Manage quarterly claim review with ... can advance, innovate, and contribute to our ongoing success. TheSr. Corporate Claims Specialistanalyzes, coordinates, and manages all aspects of GSF's insurance … more