- Guidehouse (San Marcos, CA)
- …is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other ... any and all related job duties as assigned. **_The medical biller will be working a Hybrid schedule of...Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides… more
- NTT DATA North America (Ontario, CA)
- NTT DATA is currently seeking **Senior Medical Claims Examiners (3+ years of Xcelys required)** to join our US based team. This is a 100% remote role. **Must be ... To serve as a senior-level adjudicator and SME for medical claims within the Xcelys environment. Provide... processed per day / throughput + Accuracy / audit scores + Rework / error rate + Turnaround… more
- Sedgwick (Sacramento, CA)
- …in audit exceptions. + Reviews and updates notes/diaries in claims management system as instructed. + Coordinates jurisdictional training on state specific ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Services Associate | Hybrid | Sacramento, CA Are you looking for an… more
- Stanford Health Care (Palo Alto, CA)
- …for clarity and accuracy prior to submission to ensure high-quality presentation. + Audit Response: Ensuring the medical record documentation supports medical ... America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution, reporting and corrective… more
- Robert Half Office Team (Ontario, CA)
- … claims processing team by ensuring accurate intake, sorting, and preparation of medical claims for further handling. The role is vital in maintaining ... and prepare mailing. + Reconcile processed batches within the audit database. + Create denial trailers and mail denial...+ 6 months to 1 year experience in a medical office or claims processing environment. +… more
- Sedgwick (Orange, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Liability Are you looking for...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. _As required… more
- Conduent (Los Angeles, CA)
- … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
- Lincoln Financial (Sacramento, CA)
- …experience. + Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will analyze… more
- Sedgwick (Sacramento, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Leader - Liability **PRIMARY PURPOSE** : To...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more