- Highmark Health (Sacramento, CA)
- …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
- Utilities Service, LLC (San Jose, CA)
- …**Benefits:** + Company Sponsored Retirement Plan. + Health Insurance ( Medical /Dental/Vision) + Employee Assistance Program. + Life, long-term/short-term disability ... of the Crew Members' work. + The position requires reporting, customer interaction, claims investigation, and any other management field activity that may arise. +… more
- Robert Half Accountemps (Palo Alto, CA)
- …write-offs. + Review worklists in EPIC and resolve claim edits. + Rebill claims based on denial follow-ups. + Post payments and adjustments; manage undistributed ... GED equivalent + Prior experience in patient billing, accounts receivable, or medical collections preferred. + Basic understanding of EPIC or similar healthcare… more
- National Express (Santa Ana, CA)
- …events to ensure excellence in customer service. + Ability to Investigate claims and incidents of questionable conduct, accidents etc. + Computer literacy skills ... in word processing and spreadsheets _We offer medical , dental, vision, basic life insurance coverage, holiday pay, and PTO accrual. Additionally, employees are able… more
- WelbeHealth (Elk Grove, CA)
- …is critical to enable our aligned provider networks to deliver timely medical services to frail seniors across multiple geographies. **Essential Job Duties:** _Team ... relationships with internal departments (eg, Clinical Operations, Utilization Management, Claims , Contracting, PACE Center Leadership) to ensure seamless communication,… more
- Robert Half Office Team (Fallbrook, CA)
- …dental industry regulations + Coordinate with insurance providers and handle claims processing + Monitor office inventory, vendor relationships, and supply ordering ... + 3+ years of office management experience, preferably in a dental or medical setting + Strong leadership and interpersonal skills + Familiarity with dental software… more
- Providence (Irvine, CA)
- …compliance with key healthcare regulations, including Stark Law, Anti-Kickback Statute, False Claims Act, Medicare and Medicaid billing rules, HIPAA and EMTALA. + ... Draft and review physician agreements, including medical director agreements, on-call agreements, and professional services agreements. + Prepare and review business… more
- EFI Global (Sacramento, CA)
- …**Collaborates with sales and operations managers, architects, developers, insurance adjusters, claims managers and attorneys to develop demand for your professional ... both giving and receiving** **We offer a diverse and comprehensive benefits including medical , dental vision, 401K, PTO and more beginning your first day.** ****… more
- UCLA Health (Los Angeles, CA)
- …role, you will: * Oversee delegated entities and ensure compliance * Manage claims processing and formulary utilization * Analyze drug utilization trends to identify ... opportunities * Coordinate member communications * Collaborate closely with delegated medical groups * Lead initiatives to improve medication adherence and STAR… more
- The County of Los Angeles (Los Angeles, CA)
- …(40 and over); ancestry; color; ethnicity; religious creed; protected family or medical leave status; disability; marital status; medical condition; genetic ... to take the above steps to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be a valid reason for a late… more