- Humana (Sacramento, CA)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Cedars-Sinai (Beverly Hills, CA)
- …10-the most prestigious level of certification-among more than 300 surveyed healthcare organizations. Cedars-Sinai netted high scores across multiple verticals and ... Tapestry workflows. Preferred specialty experience in Contracts and/or AP Claims build/implementation. Ability to balance multiple projects. Troubleshoots effectively… more
- UNUM (Sacramento, CA)
- …Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to… more
- Gilead Sciences, Inc. (Foster City, CA)
- …training programs support compliance with applicable laws (eg, Anti-Kickback Statute, False Claims Act), industry codes (eg, PhRMA), and internal policies. + Lead ... developing and delivering compliance training aligned with US and global healthcare regulations. + Experience supporting audits and regulatory inspections related to… more
- Cedars-Sinai (Beverly Hills, CA)
- …with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the ... to ensure the delivery of high quality, cost effective healthcare and aligned with all state and federal regulations...arranging services for members. + Provides assistance to the Claims Department, when requested. + Documents all patient specific… more
- United Therapeutics (Sacramento, CA)
- …Bachelor's Degree in a relevant discipline, preferably sciences, business, pharmacy, or healthcare with 15+ years of overall pharmaceutical, healthcare , and/or ... or, + Master's Degree with 13+ years of overall pharmaceutical, healthcare , and/or broadened industry experience with focus in reimbursement, contract strategy,… more
- Robert Half Accountemps (Sacramento, CA)
- …Receivable Clerk with immediate availability for a temporary-to-hire position in the healthcare industry. This role is ideal for someone who is detail-oriented, ... operations, including billing, collections, and payment applications. + Accurately process claims related to insurance reimbursements and patient billing. + Review… more
- Fujifilm (Sacramento, CA)
- …risks affecting the Medical Device businesses, including with respect to healthcare regulatory compliance, anti-kickback statutes, the False Claims Act, ... team providing support to the Medical Device businesses of FUJIFILM Healthcare Americas Corporation and FUJIFILM SonoSite, Inc., wholly-owned subsidiaries of… more
- The County of Los Angeles (Los Angeles, CA)
- …Evaluator, Nursing positions and support staff in the conduct of healthcare facility inspections and investigations. Essential Job Functions + Develops, interprets, ... the American Heart Association's Basic Life Support (BLS) for Healthcare Providers (CPR & AED) program . All positions...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be… more
- Evolent (Sacramento, CA)
- … healthcare regulations and standards, such as HIPAA, as well as healthcare systems and domains (FHIR/HL7, EMR/EHR, Claims , Members, Providers, Payors, etc.). ... in designing, building, integrating and maintaining data pipelines to support healthcare data integration and operations. This role involves managing data from… more