- Travelers Insurance Company (Sacramento, CA)
- …in accordance with Best Practices. Provide quality claim handling and superior customer service on assigned claims , while engaging in indemnity & expense ... management. Promptly manage claims by completing essential functions including contacts, investigation, damages...is greater than $2 million. + Provide quality customer service and ensure file quality timely coverage analysis and… 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 ... pm, Pacific Time (PT) This examination will remain open until the needs of the service are met and is subject to closure without prior notice. This announcement is… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …it most, we invite you to grow with us. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and ... Adjudication Specialist Job Details Job Location Polaris Pharmacy Services...and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims… 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 ... examination will remain open until the needs of the service are met and is subject to closure without...administrative and technical lead from a Chief, Environmental Health Specialist and may receive technical lead from an Environmental… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- Prior Authorization Specialist Job Details Job Location Polaris Specialty Pharmacy LLC - Covina, CA Salary Range $19.00 - $23.00 Hourly Job Category Pharmaceutical ... advancement to all our team members. JOB SUMMARY: The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy… more
- The County of Los Angeles (Los Angeles, CA)
- CHIEF ENVIRONMENTAL HEALTH SPECIALIST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4260745) Apply CHIEF ENVIRONMENTAL HEALTH SPECIALIST ... examination will remain open until the needs of the service are met and is subject to closure without...policies and procedures are followed by the environmental health specialist staff and also are responsible for expediting inspection… more
- LA Care Health Plan (Los Angeles, CA)
- …additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document ... Care Management Specialist II, D-SNP Team (12 month Assignment) Job...predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other… more
- University of Southern California (Newport Beach, CA)
- …ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line. The Specialist will be instrumental in obtaining written ... The Clinical Authorization Specialist will take the lead in securing medical...behavior. Preferred Qualifications: + Pref Experience in area of service . + Pref Medical Prior Authorizations or Claims… more
- The County of Los Angeles (Los Angeles, CA)
- CREDENTIALING SPECIALIST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3476028) Apply CREDENTIALING SPECIALIST Salary $65,911.68 - ... at 8:00 am (PT) Until the needs of the service are met and is subject to closure without...employment history, licensure, professional references, hospital affiliations and liability claims history by performing on-line queries from a variety… more
- Molina Healthcare (CA)
- …to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and ... appropriateness of responses per state, federal and Molina guidelines. * Meets claims production standards set by the department. * Applies contract language,… more