- Cognizant (Sacramento, CA)
- …a High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...guidelines and regulations + Experience in the analysis and processing of claims , utilization review/quality assurance procedures… more
- Humana (Sacramento, CA)
- …**Use your skills to make an impact** **Required Qualifications** **5+ years of medical claims processing /auditing or encounter data management experience** ... team leadership experience** **Demonstrated experience in managing projects effectively** ** Medical claims experience** **Additional Information** **_This position… more
- CVS Health (Sacramento, CA)
- …dollar amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, ... responsibilities. **Required Qualifications** + 2+ years of experience with medical claim processing . + 2+ years of...and interpersonal skills. + Previous experience with DG system claims processing . **Education** + Associate's degree or… more
- Humana (Sacramento, CA)
- …skills to make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...analyzing and researching medical claims + Proficient in Microsoft Office… more
- Humana (Sacramento, CA)
- …+ Grievance and appeals experience + Prior experience interpreting Member Benefits and Medical Claims + Previous experience processing medical ... + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical... Claims Administration System (CAS) + Knowledge of medical terminology + Ability to manage large volume of… more
- TEKsystems (Fresno, CA)
- …and 10-key data entry (40 WPM). + Knowledge of ERISA claims processing guidelines. Preferred Skills + Basic medical terminology knowledge. + Strong ... We are hiring Medical Claims Examiners! Must live within...We are hiring Medical Claims Examiners! Must live within 65 miles of...is ideal for someone with a strong background in claims processing , attention to detail, and a… more
- Providence (CA)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... issues. + 7 years of relevant general and professional liability claims processing or management experience **Preferred qualifications for this position… more
- Dignity Health (San Luis Obispo, CA)
- …Ability 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. **Overview** Dignity Health's Pacific Central… more
- Cognizant (Sacramento, CA)
- …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was...of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality… more
- Dignity Health (Bakersfield, CA)
- … discrepancies for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), ... accurate records for audit purposes. - Collaborate with internal departments, including claims processing , UM, compliance, and provider relations, to develop and… more