- Dignity Health (Bakersfield, CA)
- …a lead role, with strong project team management skills. - Advanced knowledge of healthcare claims processing , coding (ICD-10, CPT, HCPCS), and billing ... discrepancies for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs),… more
- 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
- Molina Healthcare (Long Beach, CA)
- …**Required Education** High School or GED **Required Experience** 3-5 years claims processing required **Preferred Education** Bachelor's Degree or equivalent ... combination of education and experience **Preferred Experience** 5-7 years claims processing preferred To all current Molina employees: If you are interested in… more
- Cognizant (Sacramento, CA)
- …* 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must ... Friday 8am - 4:30pm ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication… more
- Molina Healthcare (Long Beach, CA)
- …is involved in member enrollment, provider information management, benefits configuration and/or claims processing . + Responds to incoming calls from providers ... **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating,… more
- Molina Healthcare (Long Beach, CA)
- …to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . + Manages a caseload of claims ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims… more
- Cognizant (Sacramento, CA)
- …School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge of ... payment and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review/quality assurance procedures + Must be… more
- TEKsystems (Fresno, CA)
- …their growing team. This role is ideal for someone with a strong background in claims processing , attention to detail, and a commitment to quality assurance. The ... in Microsoft Office and 10-key data entry (40 WPM). + Knowledge of ERISA claims processing guidelines. Preferred Skills + Basic medical terminology knowledge. +… more
- Providence (CA)
- … issues. + 7 years of relevant general and professional liability claims processing or management experience **Preferred qualifications for this position ... them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,...include:** + Certified Professional Healthcare Risk Management (CPHRM) + 10+ years of medical… more
- Cognizant (Sacramento, CA)
- …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability to work at a… more