- HUB International (Roseville, CA)
- …verbal and written interactions. + High School / GED + 1-2 years of healthcare claims processing, or benefits administration preferred **KNOWLEDGE / SKILLS / ... Handles inbound calls on a queue system. + Assists clients and employees with various claims and benefit issues. + Respond to all phone calls and inquiries no later… more
- Humana (Sacramento, CA)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + ... Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Humana (Sacramento, CA)
- …from either the state agency or payer perspective + Detailed understanding of healthcare claims Travel: While this is a remote position, occasional travel ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions… more
- Highmark Health (Sacramento, CA)
- …You will proactively identify opportunities to construct and leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , ... from concept to prototype. + ** Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or… more
- Molina Healthcare (Long Beach, CA)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... **KNOWLEDGE/SKILLS/ABILITIES** + Meets and consistently maintains production standards for Claims Adjudication. + Supports all department initiatives in improving… more
- Molina Healthcare (Long Beach, CA)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating, ... investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge… more
- Molina Healthcare (Long Beach, CA)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... cost control standards. **KNOWLEDGE/SKILLS/ABILITIES** + Evaluates the adjudication of claims using standard principles and state specific policies and regulations… more
- Molina Healthcare (Long Beach, CA)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in a timely fashion and in accordance… more
- Norstella (Sacramento, CA)
- …(MD/DO), or a related field. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory data, in an academic ... are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role, you will leverage your expertise in healthcare … more
- CAI (Sacramento, CA)
- …6 years of experience or equivalent higher education. Preferred experience in healthcare claims environment and reporting development, n-tier development and ... support, and Microsoft SQL database development including relational and star schema data warehouses + Microsoft data systems certifications such as MTA, MCSA, MCSE, ITIL v3, or equivalent + 2-year degree required. Applicable certifications may substitute… more