- Rady Children's Hospital San Diego (San Diego, CA)
- …submitting provider offices), answering the phone (including all calls regarding authorization processing , claims related phone calls, and any other calls ... tasks. This includes, but is not limited to, initial authorization processing (data entry, eligibility verification, benefits verification, and requesting required… more
- Stanford Health Care (Palo Alto, CA)
- …Health Care job.** **A Brief Overview** Under the direction of the Director, Claims & Litigation Strategy, the Claims Manager oversees the workers' compensation ... Health Care, Stanford Health Care Tri-Valley, and Stanford Children's Health. The Claims Manager acts as the primary liaison with the third-party administrator (TPA)… more
- Banc of California (Santa Ana, CA)
- …throughout California and Denver, Colorado, as well as full-stack payment processing solutions through its subsidiary, Deepstack Technologies. The bank is committed ... (ACH) transactions, Large on-us & Unusual items, Stop payment, ATM/Mobile/RDC Deposits, Check Claims , Fraud alerts for Wire, ACH & Debit Card, Wire Transfer. +… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …as needed for accurate reporting of the service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing ... system and from electronic claim vendor processing , They are to correct all errors or warning...is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible to… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …payors, including but not limited to; Commercial, Medi-Cal and Managed Care professional claims . This position is responsible checking status of unpaid claims by ... ensure accurate adjudication of claim for reimbursement. They will process claims correctly following contractual arrangements the Medical Practice Foundation (MPF)… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …scheduling translation services Data entry of authorization requests Authorization processing Researching and responding to provider calls regarding authorization or ... terminology, ICD-10 codes, CPT Codes, HCPC Codes, Health Plan benefits, or claims Positive, friendly demeanor Superb listening skills with natural curiosity Strong… more
- BeOne Medicines (Emeryville, CA)
- …understanding of AI methodologies such as machine learning, natural language processing , and predictive analytics. + Experience working with organized customers, and ... / or past direct work experience at claims , EMR / EHR, real world data vendors, IDNs, Health Systems, GPOs, large Community Practices. + Demonstrated expertise in… more
- Providence (Mission Hills, CA)
- …of functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. ... Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Cedars-Sinai (CA)
- …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... claims required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred. **About Us** Cedars-Sinai is… more
- Dignity Health (Bakersfield, CA)
- … Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves ... Requirements** **Minimum Qualifications:** + Minimum of 5 years of experience in claims processing , quality assurance, or a related role within a managed care or… more
