- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... planning audits and audit work programs that address appropriate claims and financial compliance criteria for specialty health...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Providence (CA)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... + Work with defense attorneys specializing in defense of medical negligence claims + Have direct responsibility...including a retirement 401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life… more
- LA Care Health Plan (Los Angeles, CA)
- …tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with LA Care. This role works ... auditing procedures under minimal supervision during the audits of medical groups and health plans. Provide timely...audit results. Perform claims audits for all medical groups and health plans contracted with… more
- Highmark Health (Sacramento, CA)
- … + 3 years of prior experience processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years ... activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS ( Health Now… 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 ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … 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 ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … 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 ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health … 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 ... focus on collaborative business relationships, value based care, population health , or disease or care management. Medical ...population health , or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal… more
- Guidehouse (El Segundo, CA)
- …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Medical Biller** is expected to perform all areas of initial billing, secondary ... billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the...any and all related job duties as assigned. **_The medical biller will be working a Hybrid schedule based… more
- UCLA Health (Los Angeles, CA)
- …Arts Degree or equivalent combination of education and experience. + 6-8 years of medical claims payment experience in an HMO environment (ie, MSO, IPA, or ... in ensuring the timely, accurate, and compliant processing of health insurance claims . The ideal candidate will...Remittance Advice Remark Codes (RARCs). + Strong command of medical terminology. + Ability to key 6,000-8,000 keystrokes or… more