- Dignity Health (San Luis Obispo, CA)
- …patient invoices + Knowledge of payer and regulatory guidelines for medical insurance claims processing and reimbursement. + Knowledge of the processes and ... procedures related to the eligibility requirements of various insurance entities including government and private payers. + Thorough knowledge of Medicare, Medi-Cal, Physicians Choice and CenCal. **Where You'll Work** Dignity Health's Pacific Central Coast… more
- Oracle (Sacramento, CA)
- …of AI agents and multi-agent systems that orchestrate complex RCM workflows ( claims processing , charge capture, revenue integrity, denial management, and ... follow-up). Review and contribute to design docs, system diagrams, and critical code paths as needed. + **AI/ML solution delivery** Oversee end-to-end delivery of scalable AI/ML solutions, including data pipelines, model integration, inference services, and… more
- Highmark Health (Sacramento, CA)
- …within the healthcare industry. + Understanding of health plan operations, including claims processing , enrollment, billing, and customer service. + Proven track ... record of successfully managing complex projects and delivering results on time and within budget. + Strong understanding of the market and competitive landscape. + Excellent communication, interpersonal, and presentation skills. + Demonstrated ability to… more
- Datavant (Sacramento, CA)
- …following fields would be beneficial: Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing of Documents + Ability to ... stay organized while working quickly. Strong attention to detail is also required. + Passing annual Introductory HIPAA examination. (Testing to be given annually in accordance with employee review.) + Required to take and pass a 90-day ROI Certification course… more
- Grant Thornton (Newport Beach, CA)
- …projects related to revenue cycle optimization, including billing, coding, reimbursement, and claims processing , with a focus on improving financial performance ... and operational efficiency. + Extensive Healthcare Provider Experience: Minimum of 3 years' experience working directly with diverse healthcare providers, including hospitals, academic medical centers, and healthcare systems, with a comprehensive understanding… more
- Dignity Health (Rancho Cordova, CA)
- …codes to individual patient health information records for data retrieval, analysis and claims processing . This position is expected to perform duties in ... alignment with the mission and policies within the Dignity Health organization, TJC, CMS, and other regulatory agencies. **Principle Duties and Accountabilities:** + Assign codes for diagnoses, treatments, and procedures according to the appropriate… more
- Grant Thornton (Newport Beach, CA)
- …related to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing , billing, and reimbursement, with a focus on ... enhancing financial performance and operational efficiency. + Strong understanding of key healthcare regulations and initiatives, and the ability to evaluate organizational compliance with regulatory bodies such as the Office of Inspector General (OIG) and the… more
- Gilead Sciences, Inc. (Foster City, CA)
- …compliance with government and commercial pricing programs that impact contract management and claims processing . + Proficiency with Model N, SAP, and Member ... Centric or similar systems used for customer management. + Demonstrated ability to lead cross-functional initiatives, including system implementation, data profiling, and process optimization + Proven ability to resolve complex or escalated issues effectively.… more
- Sunnyside Nursing and Post-Acute Care (Torrance, CA)
- …procedural codes to individual patient information for data retrieval analysis and claims processing . Queries physicians and/or oversees the query process when ... code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Abides by the standards of ethical coding as set forth by the American Health Information Management Association and adheres to… more
- 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