- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… more
- Fluor (Fresno, CA)
- …direction of the Director and Deputy Director of the PMO/forensics & Claims , this role is responsible for developing forensic analyses and providing oversight ... also responsible for reviewing and analyzing Contractors' Time Impact Analyses and claims and assisting with the rebuttal responses. In addition to forensic analysis… more
- Philadelphia Insurance Companies (Roseville, CA)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Assistant - to join our team. Summary: Provides administrative support to claims unit(s) ... handles routine document tracking, internal/external customer/vendor communication and other basic claims functions. A typical day will include the following: *… more
- AECOM (Fresno, CA)
- …world. Join us. **Job Description** **AECOM** is seeking a **Senior Scheduler - Forensic Claims ** for one of our offices in **Fresno** **, CA** . **JOB SUMMARY** ... Rail project by performing forensic delay analyses, schedule evaluations, and claims assessments. Working within the Risk Management Office, this role helps… more
- Sedgwick (Sacramento, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of Network bills that do ... university preferred. **Experience** 2-3 years experience processing work comp claims as an examiner. Familiar with CPT, DRG and...a diverse and comprehensive benefits package including: + Three Medical , and two dental plans to choose from. +… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Recovery Manager is responsible for leading the recovery operations within the MSO Claims department. This role ... or GED + Minimum 5 years of progressive experience in healthcare claims recovery, payment integrity, or post-payment audit functions, preferably within a multi-plan… more
- Cognizant (Sacramento, CA)
- **Product Consultant - Facets Claims & Payer Domain** **Work Model: Remote** **Employment Type: Full-Time** **Job ID: 00066023611** **About the role** As a Product ... you will make an impact by leading the implementation and optimization of Facets Claims solutions for healthcare clients. You will be a valued member of the delivery… more
- Robert Half Office Team (Los Angeles, CA)
- …payment requests by responding to incoming inquiries regarding payment or claims submission. + Communicate with case managers to resolve payment authorization ... issues on pending claims . + Contribute to a team atmosphere by participating...United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance. Hired… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
- Cedars-Sinai (Los Angeles, CA)
- …Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's ... Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal… more