- Sedgwick (Sacramento, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Estimate Review Specialist **PRIMARY PURPOSE** **:** To review all estimates ... services. + Monitors, assists, tracks, and provides approval for all claims that are re-inspected by the Carrier. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES**… more
- Dignity Health (Bakersfield, CA)
- …III is an advanced-level role responsible for the detailed and accurate processing, review , and adjudication of complex healthcare claims . This position requires ... expert knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff,… more
- TEKsystems (Canoga Park, CA)
- …Key Responsibilities + Perform comprehensive utilization reviews for inpatient and outpatient claims . + Prepare medical records for review by medical directors ... active license to join our team as a Utilization Review Nurse. In this role, you will conduct retrospective...you will conduct retrospective reviews of inpatient and outpatient claims to ensure medical necessity, compliance, and timely processing… more
- University of Southern California (Alhambra, CA)
- … Specialist " analyze, investigate, mitigate, and resolve all coding-related ' claims denials' and ' claims rejections,' specific to ICD-10-CM, ICD-10-PCS, ... the denial management process for coding-related denials, triage denied claims to distinguish coding-related denials versus clinical-related denials, evaluating … more
- The County of Los Angeles (Los Angeles, CA)
- Program Specialist III, CEO - Workers' Compensation Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5097980) Apply Program Specialist III, ... The Opportunity We are pursuing qualified candidates to fill Program Specialist III, CEO positions within the Chief Executive Office's Workers' Compensation… more
- Guidehouse (San Marcos, CA)
- …Required** **:** None **What You Will Do** **:** The **Cash Applications Specialist ** - Under general supervision and according to established policies and ... Supervisor before putting payments on an unapplied invoice. + Review of statements. + Review billing statements in lockboxes for address corrections and credit… more
- Sedgwick (Sacramento, CA)
- …Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client ... claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical...rationale. + Completes medical review of all claims by reviewing medical documentation received and applying practical… more
- HCA Healthcare (Campbell, CA)
- …find this opportunity compelling, we encourage you to apply for our Contract Specialist opening. We promptly review all applications. Highly qualified candidates ... worth of each individual is recognized. Submit your application for our Contract Specialist opening with HCA Healthcare today and find out what it truly means… more
- The County of Los Angeles (Los Angeles, CA)
- ENVIRONMENTAL HEALTH SPECIALIST III Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3049497) Apply ENVIRONMENTAL HEALTH SPECIALIST III ... policies, regulations and guidelines in the area of specialization; may review and make recommendations involving environmental impact reports, and new legislation.… more
- The County of Los Angeles (Los Angeles, CA)
- ENVIRONMENTAL HEALTH SPECIALIST II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1240253) Apply ENVIRONMENTAL HEALTH SPECIALIST II ... Requirements SELECTION REQUIREMENTS Certificate* as a Registered Environmental Health Specialist issued by the California Department of Public Health. *CERTIFICATE… more