- 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 based...Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides… 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
- Cardinal Health (Sacramento, CA)
- … medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… 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
- Dignity Health (Bakersfield, CA)
- …for audit purposes. - Collaborate with internal departments, including claims processing, UM, compliance, and provider relations, to develop and implement ... **Responsibilities** The Claims Research Specialist will oversee and manage research...providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a… more
- Sedgwick (West Hills, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | West Hills, CA Are you...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. _As required… 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 Lead I Workers Comp (Calif Exp) **PRIMARY...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Sacramento, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To supervise a team of… more
- Sedgwick (Roseville, CA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Assistant Manager - Workers Compensation | Roseville, CA Are you looking for ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- Prime Healthcare (Ontario, CA)
- … Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of Claims data, the VP will identify financial ... relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of Claim Operations… more