- UNUM (Sacramento, CA)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- Sedgwick (West Hills, CA)
- …Coordinator **PRIMARY PURPOSE** **:** Analyzes reported leave requests including Family Medical Leave (FMLA), unpaid state, military and company-specific, to make ... based on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices.… more
- Sedgwick (Rancho Cucamonga, CA)
- …+ This role will be primarily responsible for **_Large Complex Property_** claims . **PRIMARY PURPOSE** **:** To investigate losses or claims internationally ... including handling accounting-based losses (business interruption and stock). + Examines claim forms and other records to determine insurance coverage. + Interviews,… more
- Cardinal Health (Fresno, CA)
- …Collections is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... + Contact insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues. + Analyze denials and underpayments… more
- Cardinal Health (Fresno, CA)
- …Practice Operations Management oversees the business and administrative operations of a medical practice. The Revenue Cycle Management team focuses on a series of ... distributing, and managing all billable services for reimbursement to the medical facility. This role works directly with insurance companies, healthcare providers,… 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
- 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
- Allied Universal (Fairfield, CA)
- 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 investigators, SIU… 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 ... Rep is responsible for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following up on unpaid… more
- Marriott (Newport Beach, CA)
- …* Works with the unemployment services provider to respond to unemployment claims ; reviews provider reports for accuracy and corrects errors. * Prepares, audits ... and distributes unemployment claim activity reports to property management. * Attends unemployment...and ensure compliance with the Privacy Act. * Ensures medical records are maintained in a separate, secure and… more