- Humana (Sacramento, CA)
- …help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the… more
- City of Long Beach (Long Beach, CA)
- …contact for internal and external stakeholders regarding leave management, retirement, medical plan enrollment, payroll, injury claims , return-to-work programs, ... managing employee leave programs, return-to-work processes, workplace accommodations, injury claims , payroll and timekeeping, and implementation of benefit plans.… more
- Actalent (Irvine, CA)
- …team. This role is critical in ensuring the integrity and compliance of marketing claims associated with our medical devices. The ideal candidate will have ... strong experience in quality systems within the medical device industry and a proven ability to trace...device industry and a proven ability to trace marketing claims to supporting engineering analyses and documentation. This individual… more
- UCLA Health (Los Angeles, CA)
- …+ Participate in team meetings, educational events, and clinic social events. + Complete medical documentation and visit claims data in the clinic's electronic ... American Board of Anesthesiology in Pain Medicine, and eligible to hold a California Medical License. This position offers a unique opportunity to join UCLA as a… more
- The Cigna Group (Los Angeles, CA)
- …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, ... Cigna's competitive position. + Creates and manages initiatives that improve total medical cost and quality. + Drives change with external provider partners by… more
- Amazon (Santa Clara, CA)
- …frontline workers (eg, customer service agents, clinicians), and back-office staff (eg, claims processing, medical coding). As a leading subject matter expert ... The AWS Healthcare AI organization includes services such as HealthScribe, Comprehend Medical , HealthLake, and more. Key job responsibilities To be successful in… more
- Law Offices of Samer Habbas Inc. PC (San Diego, CA)
- …+ Demonstrated ability to analyze, comprehend, and use legal documents such as medical bills and insurance claims + Strong working knowledge of legal ... and attorneys drafting demand packages for insurance companies, reading and comprehending medical records and bills, and creating precise summaries of case facts in… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …warning flags to ensure clean claim submission. This position is responsible for pulling medical records to submit with claims and appeals as required by payors. ... service. The incumbent completes daily processing of claim edits or rejected claims processed through the billing system and from electronic claim vendor processing,… more
- Kyndryl (Sacramento, CA)
- …platforms (eg, Pharmacy, Lab, Electronic Medical Record, Imaging, Medical Device Integrations, Contact Centers, Claims , Provider, Sales, cloud-based ... solutions, such as Pharmacy, Lab, Electronic Medical Record, Imaging, Medical Device Integrations, Contact Centers, Payer, Claims , Provider cloud-based… more
- CVS Health (Sacramento, CA)
- …for complaints and appeals received by the organization. This includes denied claims , coverage issues, medical necessity, service quality, or other concerns ... Excel, PowerPoint, Outlook). **Preferred Qualifications** + Prior experience working with claims . + Prior experience in health insurance. + Prior experience in… more