- Cedars-Sinai (CA)
- …outcome in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products ... + Supports core values, policies, and procedures. + Acquires and adjudicates medical claims for processing ; reviews scanned, EDI, or manual documents for… more
- Humana (Sacramento, CA)
- …+ High School Diploma or equivalent. + Minimum of two years' proven experience in processing and adjudicating medical claims , with a track record of accurate ... documentation and communications. + Exceptional attention to detail and accuracy in reviewing and processing claims . + Ability to quickly adapt to and learn new… more
- Humana (Sacramento, CA)
- …**Preferred Qualifications** + 2 years of Humana Experience + Knowledge of Humana Medical and Pharmacy Claims Processing Systems + Experience with ... of our caring community and help us put health first** The Medical /Financial Risk Evaluation Professional 2 is responsible for supporting the development,… more
- Robert Half Accountemps (Lynwood, CA)
- …and other medical billing software tools. Requirements * Proven experience in medical billing and claims processing . * Proficiency in using CareLogic ... play a crucial role in managing billing operations, ensuring accuracy in claims processing , and maintaining compliance with organizational standards. This is… more
- Public Consulting Group (Sacramento, CA)
- …support through claim issue research. Additional this position will assist in performing claims processing , medical record audits for all implemented ... through claim issue research. Additional this position will assist in performing claims processing , medical record audits for all implemented agencies, and… more
- Providence (Mission Hills, CA)
- …of functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. ... Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Sedgwick (Los Angeles, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist, Medical Malpractice | Professional Liability | California **PRIMARY ... PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims… more
- Dignity Health (San Luis Obispo, CA)
- …to interpret patient invoices + Knowledge of payer and regulatory guidelines for medical insurance claims processing and reimbursement. + Knowledge of ... the processes and procedures related to the eligibility requirements of various insurance entities including government and private payers. + Thorough knowledge of Medicare, Medi-Cal, Physicians Choice and CenCal. **Where You'll Work** Dignity Health's Pacific… more
- Dignity Health (Bakersfield, CA)
- … Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves ... Qualifications:** + Minimum of 5 years of experience in claims processing , quality assurance, or a related...providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a… more
- Sedgwick (Sacramento, CA)
- …+ Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only ... claims . + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal… more