- Dignity Health (Bakersfield, CA)
- …field preferred. Equivalent work experience will be considered. + Certified Medical Reimbursement Specialist (CMRS), or similar certification is preferred. ... **Job Summary and Responsibilities** The Claims Examiner III is an advanced-level role responsible...+ Expert knowledge of CPT, ICD-10, HCPCS coding, and medical terminology. + Associate's Degree - Associate's Degree in… more
- Philadelphia Insurance Companies (Mission Viejo, CA)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Specialist to join our team! Summary: Investigate, evaluate and settle more complex first ... and third party commercial auto insurance claims . A typical day will include the following: Thoroughly...communication as well as results of investigation. Evaluates each claim in light of facts; Affirm or deny coverage;… more
- Scripps Health (San Diego, CA)
- …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 following: ... one of the most respected healthcare organizations nationwide. As a Patient Account Specialist , you will be supporting the Billing Services department at our 4S… more
- Providence (Mission Hills, CA)
- **Description** Working under the general supervision of the Claims Director, provide an effective education program to advance the quality and production level of ... the Claims Department by developing and delivery claims ...valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused,… more
- University of Southern California (Alhambra, CA)
- … Specialist " analyze, investigate, mitigate, and resolve all coding-related ' claims denials' and ' claims rejections,' specific to ICD-10-CM, ICD-10-PCS, ... which might prevent or delay payment of a particular claim or group of claims . Prepares appeals...cooperatively with HIM Coding Support and/or Clinical Documentation Improvement Specialist in obtaining documentation to complete medical … more
- Morley (CA)
- …case details? If so, this role could be a perfect fit for you! As a Legal Claims Analyst at Morley, you'll play a key role in managing small automotive claims ... to support the client's defense strategies, including lemon law claims + Serve as the "Person Most Knowledgeable" (PMK)...Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 5 am… more
- The County of Los Angeles (Los Angeles, CA)
- …exposures, doses and probable biological effects; refers exposure cases to appropriate medical specialist in compliance with State law. Reviews and prepares ... (CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In… more
- Sedgwick (Sacramento, CA)
- …to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation received ... medical management of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and… more
- Sedgwick (West Hills, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance LTD Case Specialist **PRIMARY PURPOSE** **:** To analyze claims and determine benefits due ... and/or independent medical evaluations; to negotiate settlements and to make claim payments and revisions within designated authority level; and to calculate and… more
- WestCare Foundation (Fresno, CA)
- …DMC-ODS, Enhanced Care Management (ECM), and Community Supports. This position ensures claims are submitted accurately and timely directly to insurance carriers and ... Plans (MCPs) in accordance with all DHCS, payer, and organizational guidelines. The specialist works closely with fiscal, clinical, and data teams to ensure service… more