- Sedgwick (Sacramento, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor… more
- Robert Half Accountemps (Los Angeles, CA)
- …minute-taking, and tracking actionable follow-ups. Requirements EMR (Electronic Medical Records), Healthcare regulations, Audit Management, Medi-Cal, ... to enhance the effectiveness of insurance and risk management programs. + Claims Management: Collaborate with the Risk Management team to process and resolve… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR NURSING INSTRUCTOR (EMERGENCY MEDICAL SERVICES) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3309230) Apply SENIOR NURSING ... INSTRUCTOR (EMERGENCY MEDICAL SERVICES) Salary $122,010.72 - $182,634.24 Annually Location Los...the Quality Improvement program for these sections. + Reviews audit and monitoring tools on an on-going basis to… more
- Breakthru Beverage Group (Commerce, CA)
- …and executing on all Safety related programs and policies. Manages the Workers Compensation claims and works to reduce the financial impact of claims in the ... company insurance carrier to reduce the financial impact of claims in the state. The position requires strong relationship...DOT compliance. Conducts a monthly review to assess DOT audit risk, puts plans in place to correct any… more
- Fresenius Medical Center (Los Angeles, CA)
- …or other situations change. + Completes and follows up with paperwork when claims are disputed for non-payment. + Collects necessary documents to completed initial ... work progress on caseloads; Analyzes patient reports from billing systems as an audit check to ensure the correct insurance information is entered into the billing… more
- The County of Los Angeles (Los Angeles, CA)
- …operating statements, final accounting for construction and other projects, and claims for reimbursement from other government agencies or private contractors. + ... Evaluates and reconciles complex operating systems for cost reporting and claims processing reimbursements from other government agencies. + Prepares balance sheets,… more
- Sharp HealthCare (San Diego, CA)
- …investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- Highmark Health (Sacramento, CA)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- WTW (Los Angeles, CA)
- …+ **Conduct stewardship client meetings, assist underwriting in their renewal process, audit claims performance against best practices, and implement value added ... **Be responsible for the overall technical, financial, service, and audit performance and results of the partner TPA at...degree or equivalent with ten or more years of claims servicing and technical experience.** + **Knowledge at the… more