• Medical Billing Specialist III/IV - Behavioral…

    Ventura County (Ventura, CA)
    …+ 4 to less than 5 years + 5 or more years 02 Describe your experience with billing and processing claims for timely reimbursement and compliance with Medi-Cal, ... (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal,… more
    Ventura County (11/26/25)
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  • Payment Integrity Nurse Coder RN III

    LA Care Health Plan (Los Angeles, CA)
    Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Payment… more
    LA Care Health Plan (10/23/25)
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  • Division Support Specialist - PFS - Rcssd

    Rady Children's Hospital San Diego (San Diego, CA)
    JOB SUMMARY: Division Support Specialist Under the general supervision of the Supervisor, Professional Billing & Coding, responsible for compiling & providing daily, ... weekly & monthly data to Supervisor for the Specialties that they support . Will monitor & report on work queue activity, encounter management, monitor electronic … more
    Rady Children's Hospital San Diego (10/22/25)
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  • Account Manager II, Commercial Lines

    HUB International (Fresno, CA)
    …relevant experience Required Travel: No Travel Required Required Education: Associate degree (2-year degree) HUB International Limited is an equal opportunity ... decision-making. The Account Manager II also supports Producers and other support staff in obtaining, maintaining, and expanding business. **DUTIES &… more
    HUB International (12/07/25)
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  • Actuary, Medicaid Trend Analytics and Data…

    Humana (Sacramento, CA)
    …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to… more
    Humana (11/20/25)
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  • Care Management Specialist II, D-SNP Team (12…

    LA Care Health Plan (Los Angeles, CA)
    …for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Care ... or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document… more
    LA Care Health Plan (10/21/25)
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  • Senior Medical and Financial Risk Evaluation…

    Humana (Sacramento, CA)
    …**Required Qualifications** + Bachelors Degree + Minimum of 3 years of medical claims auditing experience (interpreting if claims initially paid correctly ... Minimum of 2 years Provider Payment Integrity (formally known as Financial Recovery) experience + CAS claims knowledge + Prior vendor relationship experience more
    Humana (12/09/25)
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  • Senior Payment Integrity Professional

    Humana (Sacramento, CA)
    …Finance, Healthcare Administration, Data Analytics, or a related field, or equivalent work experience . + Demonstrated experience in claims analysis, payment ... and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to… more
    Humana (11/15/25)
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  • Manager, Medical Core Content - Rare Disease

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    …use of medical information content. + Consider technology and AI to support workflow improvement **Qualifications** **Education and Experience :** + Advanced ... and external regulations. This position reports directly to the Associate Director, CNS Scientific Communications. **Job Description** **Key Responsibilities… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • (USA) Asset Protection Operations Coach Trainee

    Walmart (Manteca, CA)
    …facility level training and execution of asset protection safety functions and claims and receiving procedures by reviewing the application of policies procedures ... training needs and developing and delivering the training where needed Manages claims and receiving operations by ensuring proper policies and procedures are… more
    Walmart (11/14/25)
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