- Cardinal Health (Fresno, CA)
- …works directly with insurance companies, healthcare providers, and patients to ensure claims are processed and paid accurately and efficiently. The position requires ... Functions** + Research, correct, and resubmit rejected, and clean claims to insurance companies electronically or by paper. +...and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan… more
- Elevance Health (Los Angeles, CA)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing… more
- Robert Half Legal (San Francisco, CA)
- …their insureds. This is a NON-LITIGATION position. If you are currently litigating insurance claims and want to shift away from litigation to a hybrid remote firm, ... their insureds * Investigate and research complex matters involving detail-oriented liability claims * Analyze complex insurance contracts and policy forms and apply… more
- Robert Half Accountemps (Lynwood, CA)
- …opportunities may be available. Key Responsibilities: Submit and process medical claims accurately to Medi-Cal, commercial insurance, government payers, and other ... Manage denials and appeals, researching root causes, documenting issues, and resubmitting claims as needed. Collaborate with payers and providers to resolve complex… 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 ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... * Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...the business. BENEFITS for full time Employees + Medical, Dental , and Vision insurance + 401 (k) (available for… more
- Sedgwick (Sacramento, CA)
- …the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate ... comprehensive benefits package is offered including but not limited to, medical, dental , vision, 401k and matching, PTO, disability and life insurance, employee… more
- Oura (San Francisco, CA)
- …this role will be responsible for advising on regulatory risk, marketing claims , product labeling, corporate compliance initiatives, and will oversee the privacy ... tracking, AI-driven diagnostics, real-world data applications, and health and wellness claims . + Provide legal and regulatory oversight for clinical studies and… more
- Robert Half Legal (Oakland, CA)
- …in employment law cases, with a focus on plaintiff-side matters and disability claims . * Conduct thorough legal research and draft compelling briefs to support case ... hearings, motions, and trials. * Collaborate with clients to assess their claims and provide strategic legal guidance. * Utilize case management software to… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... states and local laws. **Company benefits** : Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more