- LA Care Health Plan (Los Angeles, CA)
- …Excel and Power Point. Requires strong knowledge of regulatory standards and claims processing ; strong analytical, oral, written and presentation skills, able ... (DHCS), Department of Managed Health Care (DMHC), Managed Risk Medical Insurance Board (MBMIB) and National Committee for Quality Assurance (NCQA) regulatory… more
- Allied Universal (Irvine, CA)
- …+ Assist with benefits administration of group benefits programs (group health, dental , vision, short-term and long-term disability, life insurance and flexible ... insurance carriers and third-party administrators for employee eligibility, claim and plan coverage inquiries, providing accurate and timely responses.… more
- Robert Half Office Team (Berkeley, CA)
- …Benefits are available to contract/temporary professionals, including medical, vision, dental , and life and disability insurance . Hired contract/temporary ... patient check-in and check-out processes, ensuring accurate data entry and payment processing in real time. * Update patient demographics and manage authorizations… more
- HUB International (Santa Barbara, CA)
- …comprehensive benefit and total compensation packages which could include health/ dental /vision/life/disability insurance , FSA, HSA and 401(k) accounts, ... on how to prepare for the unexpected. As one of the world's largest insurance brokers, our focus is dedicated to providing our customers with the peace of… more
- Robert Half Accountemps (Lynwood, CA)
- …play a crucial role in managing billing operations, ensuring accuracy in claims processing , and maintaining compliance with organizational standards. This is ... medical billing software tools. Requirements * Proven experience in medical billing and claims processing . * Proficiency in using CareLogic and other electronic… more
- TEKsystems (Canoga Park, CA)
- …to hire an experienced RN or LVN with an active license to help address claims retro review. This role focuses on reviewing inpatient and outpatient claims for ... medical necessity and compliance, ensuring timely and accurate processing in a managed care environment. Key Responsibilities: + Perform detailed utilization reviews… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …as determined by the needs of the business. BENEFITS for full time Employees + Medical, Dental , and Vision insurance + 401 (k) (available for Part Time & Full ... for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure… more
- Humana (Sacramento, CA)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and ... of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing experience + Experience in data analysis and trend monitoring… more
- Robert Half Legal (Encino, CA)
- …guide entry-level case managers in their daily tasks and responsibilities. * Facilitate claims processing with insurance carriers, including health ... experience in personal injury pre-litigation * Proficiency in handling pre-litigation cases and claims processing . * Strong ability to review and analyze medical… more
- LA Care Health Plan (Los Angeles, CA)
- …incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member ... management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines. Manages a specified… more