- 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), ... **Responsibilities** The Claims Research Specialist will oversee and...for audit purposes. - Collaborate with internal departments, including claims processing , UM, compliance, and provider relations,… more
- Sedgwick (Sacramento, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- CVS Health (Sacramento, CA)
- …Claim Benefit Specialist reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. They will act ... service inquiries and problems. **Key Responsibilities** + Reviews pre-specified claims or claims that exceed specialist... claims or claims that exceed specialist adjudication authority or processing expertise. +… 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
- CVS Health (Sacramento, CA)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Cognizant (Sacramento, CA)
- … processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... * 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must… 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
- Ventura County (Ventura, CA)
- …general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance ... years + 5 or more years 02 Describe your experience with billing and processing claims for timely reimbursement and compliance with Medi-Cal, Medicare, and… more
- The County of Los Angeles (Los Angeles, CA)
- CHIEF PROGRAM SPECIALIST , CEO - REAL ESTATE Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4905644) Apply CHIEF PROGRAM SPECIALIST , CEO - ... The Opportunity We are pursuing qualified candidates to fill Chief Program Specialist , CEO positions within the Chief Executive Office. The position has… more
- Ventura County (Ventura, CA)
- …POSITION: Under general direction, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing ... Medical Billing Specialist II - Patient Financial Services Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4940099) Apply Medical Billing … more