- J&J Family of Companies (Sacramento, CA)
- …building strong customer relationship + Demonstrated expertise with both pharmacy and medical /buy & bill benefits, coding, and billing + Reimbursement or ... support needs + Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …the writing of scheduled medications - Must obtain within one year of employment Medicare Billing number (NPI- National Provider Identifier) - Must obtain within ... the writing of scheduled medications - Must obtain within one year of employment Medicare Billing number (NPI- National Provider Identifier) - Must obtain within… more
- Cedars-Sinai (Beverly Hills, CA)
- …management as appropriate. + Responsible for invoicing sponsors, patient research billing , reimbursement to ancillary departments, and payment tracking. Issues and ... System. Reviews and finalizes clinical trials calendars to ensure agreement with Medicare coverage analysis and clinical trial budget. + Performs Medicare … more
- Stanford Health Care (Palo Alto, CA)
- …levels of the organization + Knowledge of accounts receivable software systems and medical billing operations + Familiarity with medical reimbursement ... and medical terminology + Knowledge of payer landscape, including Medicare , Medicaid, Workers' Compensation, Managed Care, or other Commercial insurance **These… more
- Highmark Health (Sacramento, CA)
- …all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... billing and documentation related to DRGs, APCs, CPTs and...in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine… more
- The County of Los Angeles (Los Angeles, CA)
- …for health and/or mental health care provided under Federal, State and Special medical aid programs or prepares yearly budget requests, annual financial plans and ... rules and regulations and result in maximum revenue collection. + Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. + Analyzes… more
- UCLA Health (Los Angeles, CA)
- Description The Business Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison between business units, IT teams, and ... other related field required + Minimum of five years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required +… more
- UCLA Health (Los Angeles, CA)
- Description As a member of the Medicare Advantage Operations team, Business Data Analyst is instrumental in independently developing the detailed requirements ... related field required + Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required + Minimum… more
- Cognizant (Sacramento, CA)
- …clinical denials including but not limited to referral, preauthorization, medical necessity, non-covered services, investigational/experimental and billing ... the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member… more
- Dignity Health (Sacramento, CA)
- …diversities of clients. Ethical and legal issues. Community resources. Billing and documentation requirements. Effective verbal and written communication skills. ... and standards. Manage significant electronic documentation functions necessary to support insurance billing . Ability to manage the case load and maintain schedule to… more