- 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
- 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
- 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
- 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
- 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
- Sedgwick (Roseville, 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
- TEKsystems (Fresno, CA)
- …of Claims . Claims Examiner I is responsible for reviewing and processing medical , dental, vision and electronic claims in accordance with state, ... * A minimum of one (1)year experience as a Claims Examiner for medical , dental claims...of Employee Retirement Income Security Act of 1974 (ERISA) claims processing /adjudication guidelines.* Examine a problem, set… more