- Cognizant (Sacramento, CA)
- …and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review/ quality assurance procedures + Must be able ... business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical**... Processors to join our growing team. The **Medical** ** Claims Processor** is responsible for the timely and accurate… more
- Cognizant (Sacramento, CA)
- …1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. + Excellent ... and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and… more
- Cognizant (Sacramento, CA)
- …* 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. * Must be ... claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate… more
- Elevance Health (Walnut Creek, CA)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims … more
- Sharp HealthCare (San Diego, CA)
- …reasonableness checks). Providing efficient and cost-effective solutions as required.Oversees all claims testing and quality assurance activities and ... and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit… more
- Sharp HealthCare (San Diego, CA)
- …checks) provide efficient, cost-effective solutions as directed.Serve as the lead on claims testing and quality assurance activities and assisting ... investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or… more
- ICW Group (Pleasanton, CA)
- …support appropriate financial forecasting, reinsurance reporting and risk scoring. + Oversees quality assurance processes and conducts regular audits of complex ... here! **PURPOSE OF THE JOB** The Senior Manager Major Claims Unit (MCU) leads a team of specialized complex... Unit (MCU) leads a team of specialized complex claims professionals focused on managing and resolving catastrophic, high-dollar… more
- TEKsystems (Fresno, CA)
- …background in claims processing, attention to detail, and a commitment to quality assurance . The position involves adjudicating a variety of claim types, ... and secure handling of confidential data. + Meet departmental productivity and quality standards. + Process low-level claims , re-pricing corrections, and respond… more
- Prime Healthcare (Chino, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/222648/risk-management-manager quality - assurance /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... (2014-2022), Chino Valley Medical Center has been recognized nationally for its quality , including as among the 100 Great Community Hospitals by Becker's Hospital… more
- Prime Healthcare (Redding, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/218087/risk-management-coordinator quality - assurance /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... an award-winning team of dedicated professionals committed to our core values of quality , compassion and community! Shasta Regional Medical Center, a member of Prime… more