- Cognizant (Sacramento, CA)
- …a High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...Responsibilities** + Responsible for reviewing the data in the claim processing system (Facets) and comparing it… more
- CVS Health (Sacramento, CA)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience ... or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes… more
- CVS Health (Sacramento, CA)
- …materials to manage job responsibilities. **Required Qualifications** + 2+ years of experience with medical claim processing . + 2+ years of experience in a ... claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing...on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical… more
- Sedgwick (San Diego, CA)
- …under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/ processing with claimant and ... + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only … more
- Sedgwick (Sacramento, CA)
- …Coverage Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- Dignity Health (Bakersfield, CA)
- …for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), ... accurate records for audit purposes. - Collaborate with internal departments, including claims processing , UM, compliance, and provider relations, to develop and… more
- Sedgwick (Roseville, CA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Sedgwick (Brea, CA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Adecco US, Inc. (San Diego, CA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Sedgwick (Sacramento, CA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more