- Sedgwick (Sacramento, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Surveyor Marine National Sr **PRIMARY PURPOSE** **:** To be responsible for the ... the cause of loss. + Receives and reviews new claims and maintains data integrity in the claims...dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account,… more
- Humana (Sacramento, CA)
- …community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Medtronic (Irvine, CA)
- …of US and International promotional labeling material, including the creation of a claims matrix database and claims objects. + Lead AI/ML adoption in ... content and claims management to support automation and enhance process efficiency....work 20+ hours per week: Health, Dental and vision insurance , Health Savings Account, Healthcare Flexible Spending Account, Life… more
- Humana (Sacramento, CA)
- …data mining, detects anomalies in data to identify and collect overpayment of claims . Contributes to the investigations of fraud waste and our financial recovery. ... provider contract payments in our payer systems, and by ensuring correct claims payment. Begins to influence department's strategy. Makes decisions on moderately… more
- Sedgwick (West Hills, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Leave of Absence Coordinator **Our teams connect! We collaborate onsite and have ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Sedgwick (Sacramento, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, ... to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI...dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account,… more
- LA Care Health Plan (Los Angeles, CA)
- …management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines. Manages a specified ... additional service needs according to specific program guidelines. Uses claims processing and care management software to look up...group or managed care setting, such as a health insurance environment and/or experience as care manager in home… more
- Elevance Health (Cerritos, CA)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing… more
- Elevance Health (Los Angeles, CA)
- …as single point of service support (eg, phone and e-mail inquiries, claims , enrollment, billing) to Elite Broker contacts (Brokers, General Agents, Agencies, etc.) ... plan offerings, have issues that are impacting multiple service areas such as claims , eligibility, etc. and provide onsite support as needed) with timely and… more
- Prime Healthcare (Lynwood, CA)
- …Coordinator is responsible for gathering, reviewing, and approving internal billing claims ; setup, verification and updating insurance account information; ... preparing related billing claims data reports; coordinates Medical billing claims submission via electronic data interface (EDI); functions as liaison with LA… more