- Insight Global (Santa Barbara, CA)
- …loading expenses and revenue into the ledger. Extract and translate data from QNXT claims processing system into feeds required by Finance. Develop and maintain ... processes. This role will support the Finance & Accounting team by translating claims and revenue data into actionable insights and ensuring accurate ledger entries.… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance ... operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors.… more
- CVS Health (Sacramento, CA)
- …key payers to discuss reimbursement issues and payer publication notices affecting claims processing changes + Ensure daily reconciliation of electronic claim ... are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and...variances, and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the… more
- LA Care Health Plan (Los Angeles, CA)
- …incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member ... stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data… more
- Insight Global (San Diego, CA)
- …or GED required. o Minimum 1+ year experience in healthcare, Medicare, or claims processing . o Intermediate Excel skills (formulas, VLOOKUP, pivot tables). o ... weekly PDE cycle submissions (previously 3-week cycles). o Convert claims data into CMS-compliant PDE files using internal systems....files for submission to CMS vendor (CSSC). * Data Processing & Reporting o Manipulate Excel files for cycle… more
- City and County of San Francisco (San Francisco, CA)
- …who passed probation;* AND + EXPERIENCE: Five (5) years of experience billing, claims processing , and/or collecting healthcare service reimbursements or medical ... and tracking of issues; + Performs revenue analysis related to charge errors, claims submission volume, denials and trends based on claim type and/or payer,… more
- Robert Half Legal (Encino, CA)
- …case managers in their daily tasks and responsibilities. * Facilitate claims processing with insurance carriers, including health insurance, Medicare, ... personal injury pre-litigation * Proficiency in handling pre-litigation cases and claims processing . * Strong ability to review and analyze medical records and… more
- City and County of San Francisco (San Francisco, CA)
- …direction, the Worker's Compensation Supervisor assists and provides first-line oversight of claims adjusting and processing teams for the Workers' Compensation ... supervising the review, analysis, investigation and disposition of workers' compensation claims and reports. Provides claims supervision of confidential complex… more
- City of Long Beach (Long Beach, CA)
- …or self-insured, self-administered employer. KNOWLEDGE, SKILLS, AND ABILITIES: + Knowledge of processing benefit notices and claims ; + Skill in organizing work ... WORKERS COMPENSATION CLAIMS ASSISTANT Print (https://www.governmentjobs.com/careers/longbeach/jobs/newprint/5085519) Apply WORKERS COMPENSATION CLAIMS … more
- Insight Global (Irvine, CA)
- …management - Proficiency with Paragon and related billing tools - Familiarity with claims processing software and clearinghouse platforms - Ability to process ... and state regulations * Accurately prepare, review, and submit claims to maximize reimbursement and minimize denials * Utilize...and submit claims quickly and accurately - Strong knowledge of Medicare… more