- Sharp HealthCare (San Diego, CA)
- …Auditor will analyze and assess Sharp's potential risks using SHC's billing and coding claims data, risk assessment data, MDAudit risk analyzer software, OIG ... Sharp HealthCare 's (SHC) compliance audit function and maintaining Sharp HealthCare 's view of coding , billing and reimbursement compliance audits. **Required… more
- Guidehouse (San Marcos, CA)
- …or customer service. + Working knowledge can be of the following: insurance claims , billing, coding , follow-up, finance, accounting or customer service related ... Required** **:** None **What You Will Do** **:** The ** Medical Biller** is expected to perform all areas of...billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the… more
- Humana (Sacramento, CA)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from...one of these qualifications for 4 years) * MS-DRG coding /auditing experience * Experience reading and interpreting claims… more
- Prime Healthcare (Ontario, CA)
- …to all levels using Microsoft Office applications. + Strong knowledge of medical coding (ICD-10, HCPCs/CPT, etc.) Preferred qualifications: + Certified ... to improve the quality and minimize process cost of Claims for all Prime Healthcare 's self-insured Employee...Professional Coding Certification, AIC, ARM, or equivalent. + Familiarity with… more
- Highmark Health (Sacramento, CA)
- …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- Cognizant (Sacramento, CA)
- …High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...of physician practice and hospital coding , billing, and medical terminology, CPT, HCPCS,… more
- Dignity Health (Bakersfield, CA)
- …within a managed care or healthcare environment. + Strong knowledge of healthcare claims processing, coding (ICD-10, CPT, HCPCS), and billing practices ... **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the...as SQL, SAS + Previous experience working directly with healthcare providers or within a provider network setting +… more
- Dignity Health (Bakersfield, CA)
- …responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims . This position requires expert knowledge of claims ... Requirements** **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing, with at least 2...advanced role + Expert knowledge of CPT, ICD-10, HCPCS coding , and medical terminology. + Associate's Degree… more
- Molina Healthcare (Long Beach, CA)
- …standards. **Knowledge/Skills/Abilities** * Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously ... years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review. **Required License, Certification, Association** Active,… more
- Sharp HealthCare (San Diego, CA)
- …coverage policies, and/or reimbursement policies. + Working knowledge and experience with medical coding (HCPCS, CPT, ICD-10) + Excellent organizational and ... and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit… more
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