- 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
- Sedgwick (West Hills, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Leave of Absence Coordinator **Our teams connect! We collaborate onsite and have ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Sedgwick (Sacramento, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Marine Surveyor Sr **PRIMARY PURPOSE** : To inspect damaged cargo to determine ... collisions or motor failures. + Receives and reviews new claims and maintains data integrity in the claims...college or university preferred. Valid driver's license and current insurance coverage required, along with motor vehicle record that… more
- Sedgwick (Sacramento, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Surveyor Marine National Sr **PRIMARY PURPOSE** **:** To be responsible for the ... the cause of loss. + Receives and reviews new claims and maintains data integrity in the claims...package is offered including but not limited to, medical, dental , vision, 401k and matching, PTO, disability and life… 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
- Medtronic (Irvine, CA)
- …available to those regular employees who work 20+ hours per week: Health, Dental and vision insurance , Health Savings Account, Healthcare Flexible Spending ... International promotional labeling material, including the creation of a claims matrix database and claims objects. +...Account, Life insurance , Long-term disability leave, Dependent daycare spending account, Tuition… more
- Humana (Sacramento, CA)
- …data mining, detects anomalies in data to identify and collect overpayment of claims . Contributes to the investigations of fraud waste and our financial recovery. ... provider contract payments in our payer systems, and by ensuring correct claims payment. Begins to influence department's strategy. Makes decisions on moderately… more
- Sedgwick (Sacramento, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, ... to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI...package is offered including but not limited to, medical, dental , vision, 401k and matching, PTO, disability and life… more
- LA Care Health Plan (Los Angeles, CA)
- …management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines. Manages a specified ... additional service needs according to specific program guidelines. Uses claims processing and care management software to look up...group or managed care setting, such as a health insurance environment and/or experience as care manager in home… more
- Elevance Health (Cerritos, 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