- The County of Los Angeles (Los Angeles, CA)
- …to take the above steps to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be a valid reason for late ... Please note, you may be required to submit documentation from a qualified medical provider or other qualified professional to support your request for a testing… more
- Sharp HealthCare (San Diego, CA)
- …and group agreements; Operations Manual; benefit matrices; and other administrative and medical guidelines, policies, and procedures. Works closely with the Chief ... Medical Officer (CMO) who is responsible for all decisions...and grievances. **Required Qualifications** + 3 years' experience in claims , utilization review, appeals or member services in a… more
- BrightSpring Health Services (Union City, CA)
- …to fill prescriptions and to obtain reimbursement/payment , utilizing k nowledge of drugs, medical nomenclature, and the metric system + Read s and input s written ... prescriptions and medical data, including performing drug calculations and interpreting physicians'...Identifies and resolves issues of denials or follow-up of claims , by maintaining current knowledge of Medicaid claim… more
- Oura (San Francisco, CA)
- …field data to inform decisions that reduce field failures, minimize warranty claims , and ensure ongoing improvements across the entire supply chain. You'll be ... measure the impact of quality improvements, directly contributing to reduced warranty claims . + Ensure continuous improvement in the supply chain: Conduct thorough… more
- The County of Los Angeles (Los Angeles, CA)
- …to take the above steps to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be a valid reason for late ... Please note, you may be required to submit documentation from a qualified medical provider or other qualified professional to support your request for a testing… more
- The County of Los Angeles (Los Angeles, CA)
- …applicant's responsibility to take steps to view correspondence, and we will not consider claims of missing notices to be a valid reason for re-scheduling an exam ... (40 and over); ancestry; color; ethnicity; religious creed; protected family or medical leave status; disability; marital status; medical condition; genetic… more
- The County of Los Angeles (Los Angeles, CA)
- …applicant's responsibility to take steps to view correspondence, and we will not consider claims of missing notices to be a valid reason for re-scheduling an exam ... (40 and over); ancestry; color; ethnicity; religious creed; protected family or medical leave status; disability; marital status; medical condition; genetic… more
- Pfizer (South San Francisco, CA)
- …forecasting, predictive modeling. + Consulting experience and experiences of analyzing patient/ claims data is highly desired. + Deep understanding of pharmaceutical ... product reimbursement process for both medical and pharmacy products. + Demonstrated ability in managing...sets. + Expertise of using common pharmaceutical and payer claims datasets (IQVIA LAAD) and copay/affordability data sources (CoverMyMeds,… more
- The County of Los Angeles (Los Angeles, CA)
- …applicant's responsibility to take steps to view correspondence, and we will not consider claims of missing notices to be a valid reason for re-scheduling an exam ... may be required to submit documentation from a qualified medical provider or other qualified professional to support your...to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be… more
- Centene Corporation (Sacramento, CA)
- …fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare ... mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect...Healthcare, related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, … more