- Dignity Health (Bakersfield, CA)
- … discrepancies for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), ... **Responsibilities** The Claims Research Specialist will oversee and...for audit purposes. - Collaborate with internal departments, including claims processing , UM, compliance, and provider relations,… more
- Sedgwick (Sacramento, CA)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist ... **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury… more
- Golden State Foods (Irvine, CA)
- … Claims Specialistanalyzes, coordinates, and manages all aspects of GSF's insurance claims (workers compensation, auto, and general liability) process to ... claims handling procedures and program enhancements to streamline claims processing and mitigate loss + Manage...and employee safety + Successful and progressive history of insurance claims administration including the management of… more
- Cognizant (Sacramento, CA)
- … processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... * 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must… more
- Banc of California (Santa Ana, CA)
- …throughout California and Denver, Colorado, as well as full-stack payment processing solutions through its subsidiary, Deepstack Technologies. The bank is committed ... (ACH) transactions, Large on-us & Unusual items, Stop payment, ATM/Mobile/RDC Deposits, Check Claims , Fraud alerts for Wire, ACH & Debit Card, Wire Transfer. +… more
- Ventura County (Ventura, CA)
- …general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance ... years + 5 or more years 02 Describe your experience with billing and processing claims for timely reimbursement and compliance with Medi-Cal, Medicare, and… more
- Ventura County (Ventura, CA)
- …POSITION: Under general direction, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing ... (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare, Commercial Insurance and/or Medi-Cal. + Medi-Cal/Medicare/… more
- Cedars-Sinai (CA)
- …Hospitals! **What will I be doing in this role?** The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and ... Professional Fee billing and collections. Duties include reviewing and submitting claims to payors, performing account follow-up activities, updating information on… more
- City and County of San Francisco (San Francisco, CA)
- …contracts to ensure compliance with program rules. The Prevention and Problem Solving Specialist conducts key quality insurance reviews to prevent fraud and ... Unified School District, or San Francisco City College, working within the Program Specialist (2913) classification. San Francisco is a vibrant and dynamic city, on… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- Lead Prior Authorization Specialist Job Details Job Location Polaris Specialty Pharmacy LLC - Covina, CA Salary Range $28.00 - $29.00 Hourly Job Category ... to all our team members. JOB SUMMARY: The Lead Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy… more