- Centene Corporation (Sacramento, CA)
- …in Business, Criminal Justice, Healthcare, related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit , medical ... and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure...mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Supervises the evaluation of control systems. + Supervises the review of audit findings prepared by the County Auditor and outside agencies and supervises the ... professional accounting systems analysis work in connection with the internal audit , development, evaluation, and review of large-scale and complex fiscal control… more
- Grant Thornton (San Francisco, CA)
- …derivative models, equity instruments in complex capital structures, and contingent claims , utilizing advanced statistical and financial concepts such as stochastic ... a licensed, certified public accounting (CPA) firm that provides audit and assurance services ― and Grant Thornton Advisors...Thornton interns are eligible to participate in the firm's medical , dental and vision insurance programs and the firm's… more
- City and County of San Francisco (San Francisco, CA)
- …to the general duties above: + Detects, investigates, and prevents fraudulent claims for public assistance to avoid welfare fraud and other financial crimes. ... visits, often in situations requiring communication with individuals who may have medical (eg, drug or alcohol), psychiatric, or aggressive behavior problems, by… more
- Humana (Sacramento, CA)
- …Compliance team that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This ... action plans, as needed. You will participate in all phases of the audit process including evaluating control design and adequacy, testing to ensure adherence with… more
- Robert Half Accountemps (Napa, CA)
- …and filing systems. * Develop and utilize complex spreadsheets and databases for audit analysis using Microsoft Office applications. * Process state claims ... regulations. * Uphold confidentiality and professionalism in all financial and audit activities. Requirements * Proficiency in account coding and accounting software… more
- DoorDash (San Francisco, CA)
- …accuracy, team efficiency, and our ability to meet financial reporting and audit requirements + Collaborate closely with outside counsel, in-house attorneys, ... claims professionals, and safety teams to move cases forward...been reviewed by an independent auditor. Results of the audit may be viewed here: Covey (https://getcovey.com/nyc-local-law-144) Compensation The… more
- Tutor Perini (Menlo Park, CA)
- …to come. Across California our notable projects include Kaiser San Leandro Medical Center, San Diego Central Courthouse, Scripps, Encinitas Acute Care Center, ... compliant). Proactively manage financial risks and remediation in order to avoid significant audit issues. Primary leadership role in working with outside audit … more
- Robert Half Management Resources (San Mateo, CA)
- …benefits administration, including managing leave of absence processes, workers' compensation claims , and 401k program updates. * Coordinate and execute open ... return to work. * Process and document workers' compensation claims , acting as a liaison with third-party providers and...the HR system to maintain oversight and accuracy. * Audit employee records and ensure data integrity while maintaining… more
- Aveanna Healthcare (Seal Beach, CA)
- …Tickets to correct and update client's invoices. * Works with Respite Biller to ensure claims are refiled and/or billed to the Regional Centers in a timely manner. * ... Understands Regional Center specific requirements for submitting claims (ie, includes Respite biller's notes, invoices, etc.). *...Computer literate and ability to type, file and maintain audit records. * Strong Excel skills * Excellent research… more