- Elevance Health (Cerritos, CA)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...in good faith believes is the range of possible compensation for this role at the time of this… more
- Elevance Health (Walnut Creek, CA)
- …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 ... Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and...in good faith believes is the range of possible compensation for this role at the time of this… more
- CDM Smith (Walnut Creek, CA)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...**Pay Range Minimum:** $59.85 **Pay Range Maximum:** $126.00 **Additional Compensation :** All bonuses at CDM Smith are discretionary and… more
- Robert Half Accountemps (Los Angeles, CA)
- …Specialist will be tasked with managing and processing medical insurance claims for acute care facilities, ensuring accuracy and efficiency in collections. ... offers an opportunity to utilize your expertise in UB-04 claims while collaborating with internal and external stakeholders to...to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on… more
- Zurich NA (Sacramento, CA)
- …School Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support area OR + Zurich Certified Insurance Apprentice including an ... and 8 or more years of experience in the Claims or Underwriting Support are OR AVP, Underwriting Director...and renewal business + Strong presentation skills At Zurich, compensation for roles is influenced by a variety of… more
- Prime Healthcare (Lynwood, CA)
- …is responsible for gathering, reviewing, and approving internal billing claims ; setup, verification and updating insurance account information; verifying ... eligibility; preparing related billing claims data reports; coordinates Medical billing claims ...submissions. Pay Transparency St. Francis Medical Center offers competitive compensation and a reasonable compensation estimate for… more
- Humana (Sacramento, CA)
- …**Required Qualifications** + Bachelors Degree + Minimum of 3 years of medical claims auditing experience (interpreting if claims initially paid correctly in the ... Payment Integrity (formally known as Financial Recovery) experience + CAS claims knowledge + Prior vendor relationship experience/knowledge + Intermediate knowledge… more
- Humana (Sacramento, CA)
- …community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Sedgwick (West Hills, CA)
- …and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow ... processes. + Analyzes FMLA and other paid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with… more
- Zurich NA (San Francisco, CA)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s...and experience. We follow local laws to ensure fair compensation . You may also be eligible for bonuses and… more