- Emanate Health (Covina, CA)
- …decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete ... #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying… more
- Providence (CA)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... Program:** + Communicate with patients, claimants, caregivers, providers, leadership + Review and analyze medical records, interview witnesses, assist with… more
- Cognizant (Sacramento, CA)
- …of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent ... to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication...with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or… more
- TEKsystems (Fresno, CA)
- … Claims . Claims Examiner I is responsible for reviewing and processing medical , dental, vision and electronic claims in accordance with state, federal and ... Health Insurance Payment Demand (HIPD) claims . The Claims Examiner I will thoroughly review , analyze,...* A minimum of one (1)year experience as a Claims Examiner for medical , dental claims… more
- Ryder System (Sacramento, CA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Senior Claims Representative handles complex and mid-to-high exposure bodily injury...all relevant laws and regulations as well as related medical and legal terminology + Requires strong claim technical… more
- Sedgwick (Riverside, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract ... authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated ...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. _As required… more
- Illumination Foundation (Riverside, CA)
- …including but limited to ICD 10 Diagnosis codes, CPT codes for services rendered etc. * Review and follow up on outstanding unpaid claims * Review any ... Angeles County and the Inland Empire. Job Description The Claims Specialist is responsible for accuracy of claims...to claim submission via provider or DHCS portals * Review client records to extract applicable data necessary for… more
- Sedgwick (Riverside, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract ... authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated ...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Rancho Cordova, CA)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Adjuster | Rancho Cordova, CA (Hybrid 2 Days) Are you looking for… more
- Sedgwick (Orange, CA)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Fortune Best Workplaces in Financial Services & Insurance Workers Compensation | Claims Adjuster | Dedicated Account | Hybrid - Orange, CA **PRIMARY PURPOSE**… more