- Providence (Anaheim, CA)
- …obligations by providing the administrative and operational support necessary to manage medical malpractice risk, claims , and patient safety interface functions. ... Clinical Network (PCN) is seeking an experienced and collaborative Director of Medical Group Risk Management & Malpractice for oversight of a comprehensive… more
- Kemper (Chatsworth, CA)
- …position focuses solely on the analysis & negotiation of bodily injury claims that are ordinarily assigned after the initial coverage determination, property damage ... handling, and investigation are completed. Claim inventories primarily involve attorney-represented files with varying degrees...and resolve moderate to severe, including fatal, bodily injury claims with prompt review and respond to all demands,… more
- LA Care Health Plan (Los Angeles, CA)
- …and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process ... relevant coding elements. Audits can include inpatient, outpatient, and professional claims . Serves cross functionally with Utilization Management, Medical … more
- Cardinal Health (Sacramento, CA)
- …and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard billing ... is responsible for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following up on unpaid… more
- Sedgwick (Sacramento, CA)
- …Services & Insurance Executive General Adjuster **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other ... including handling accounting-based losses (business interruption and stock). + Examines claim form and other records to determine insurance coverage. + Interviews,… more
- CVS Health (Sacramento, CA)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working… more
- Centene Corporation (Sacramento, CA)
- …in Business, Criminal Justice, Healthcare, related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, ... and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure...mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect… more
- Cardinal Health (Sacramento, CA)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Scripps Health (San Diego, CA)
- …one who thrives in a fast-paced environment and has a passion for insurance and medical claims . As a Patient Account Specialist, you will be responsible for the ... guidelines. * Follows-up with insurance carriers timely on unpaid claims until claims are paid or only...in an efficient, timely, and effective manner. Secures needed medical documentation required or requested by insurances. * Works… more
- Allied Universal (San Jose, CA)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more