- Canon USA & Affiliates (Sacramento, CA)
- …and review of collaterals for clinical accuracy and adherence to clinical claims . Effectively interacts with multiple teams including R&D, global and local business, ... protocol development, data acquisition, phantom studies, equipment evaluations, post processing , and development of presentations. + Provide evidence-based guidance… more
- Movn Health (CA)
- …experienced Senior Medical Biller & A/R Specialist to take full ownership of claims processing and accounts receivable recovery. This is a hands-on, senior-level ... payer systems is essential. Functional Responsibilities + Submit clean claims via EHR to all payers within 24 hours...Strong command of medical coding (ICD-10, CPT, HCPCS) and healthcare compliance (HIPAA, CMS) + Proven success in reducing… more
- Otsuka America Pharmaceutical Inc. (San Francisco, CA)
- Otsuka America Pharmaceutical Inc. is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." ... In its evolved customer engagement model, a Neuroscience Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools, offering… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …as needed for accurate reporting of the service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing ... system and from electronic claim vendor processing , They are to correct all errors or warning...is responsible for pulling medical records to submit with claims and appeals as required by payors. Responsible 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 ... Medical Group and IPA's to ensure the delivery of high quality, cost-effective healthcare and aligned with all state and federal regulations and guidelines. Duties… more
- Evolent (Sacramento, CA)
- …Be Doing:** Job Description **Analyst, Integration Quality** Integration testing in the healthcare ecosystem requires complete end to end testing in the specialty ... source & target integrity across various databases supporting transaction processing based on the end-to-end data flow + create...work experience + General knowledge of data flow and healthcare end to end system landscape + Good knowledge… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …Competencies** **K** **nowledge** - Experience working in the pharmaceutical and/or healthcare industry. - Knowledge and experience with preparation of global ... clinical development, project management, quality assurance, etc.) in pharmaceutical or healthcare related industry. Experience with FDA or other health authority… more
- Humana (Sacramento, CA)
- …to make an impact** **Required Qualifications** **5+ years of medical claims processing /auditing or encounter data management experience** **Demonstrated deep ... to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …provider offices), answering the phone (including all provider calls regarding authorization processing , claims related phone calls, and any other calls received ... tasks. This includes, but is not limited to, initial authorization processing , (data entry, eligibility verification, benefits verification, and requesting required… more
- The County of Los Angeles (Los Angeles, CA)
- …typically report to a higher-level manager and are responsible for processing and maintaining credentialing documentation for review by the credentialing review ... education, employment history, licensure, professional references, hospital affiliations and liability claims history by performing on-line queries from a variety of… more