- Cardinal Health (Fresno, CA)
- …Insurance Collector is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of ... School Diploma, GED or equivalent work experience, preferred + Strong knowledge of insurance claim processing and denial management preferred. + Familiarity with… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… more
- Oura (San Francisco, CA)
- …this role will be responsible for advising on regulatory risk, marketing claims , product labeling, corporate compliance initiatives, and will oversee the privacy ... tracking, AI-driven diagnostics, real-world data applications, and health and wellness claims . + Provide legal and regulatory oversight for clinical studies and… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… 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 ... new patients in the system, including patient demographics, verifying insurance , eligibility and claim information is accurate. Incumbent will...system and from electronic claim vendor processing , They are to correct all errors or warning… more
- ICW Group (San Diego, CA)
- …in designing and optimizing data models that support actuarial analysis, policy processing , claims processing , underwriting, compliance reporting, and ... scalable data models (conceptual, logical, and physical) tailored for Workers Compensation Insurance data such as claims , policies, premiums, exposures, and… more
- Humana (Sacramento, CA)
- …make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,… 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
- Highmark Health (Sacramento, CA)
- …leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , and clinical data to uncover hidden patterns, propagate insights ... databases (eg, Neo4j, ArangoDB, Amazon Neptune, Ontotext GraphDB), distributed graph processing frameworks (eg, Apache Spark GraphX, Dask-Graph), and leading GML… 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