- Insight Global (Burbank, CA)
- …answers and alternative solutions; implementing solutions; addressing unresolved problems - Review and research incoming healthcare claims by navigating multiple ... Knowledge of medical terminology - Ability to research and verify claims payment, benefits, and eligibility issues - Strong knowledge of benefits plans, policies… more
- Fujifilm (Sacramento, CA)
- …be an integral part of the legal team providing support to the Medical Device businesses of FUJIFILM Healthcare Americas Corporation and FUJIFILM SonoSite, Inc., ... (HLUS). The Senior Counsel, reporting to the Division General Counsel, Medical Devices, will be an experienced commercial transactions lawyer, responsible for… more
- Humana (Sacramento, CA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Kemper (Cerritos, CA)
- …metrics. **POSITION RESPONSIBILITIES:** + Manages the day-to-day operations for assigned claims staff by establishing schedules and priorities, coaches employees in ... reviewing, analyzing, investigating, negotiating and settling claims in compliance with Kemper Claims Standards....aligned unit to include reviews on open inventory and review of files to assess overall quality. + Builds… more
- Cognizant (Sacramento, CA)
- …teams. **In this role, you will:** + Review and resolve denied or rejected medical claims due to coding errors, ensuring accurate coding and billing based on ... **Cardiovascular Medical Coder** We strive to provide flexibility wherever...working with various departments to prevent future denials. + Review documentation to code diagnosis and procedures specific to… more
- Adecco US, Inc. (Fountain Valley, CA)
- …reporting + Identify unbilled claims and obtain repair orders as necessary for review + Review and validate factory warranty claim edits, causal part codes, ... This role is responsible for the timely analysis and submission of invoices and claims , as well as tracking vehicle buyback assets. The ideal candidate will have… more
- Humana (Sacramento, CA)
- …and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Sharp HealthCare (San Diego, CA)
- …requirements for the position, and employer business practices. **What You Will Do** To review more complex requests for medical care and services, if part of ... nursing facility admission including requests for outpatient care, retrospective claim review , medical equipment, medication issues and acquisition, home health… more
- AON (Los Angeles, CA)
- …client service for assigned book of business including billing, policy collection, review and transmittal in accordance with established service standards. + Liaise ... including technical writing and verbal presentation skills. + Establish understanding of claims administration process and utilize the claims and legal advocacy… more
- Elevance Health (Walnut Creek, CA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more