- LA Care Health Plan (Los Angeles, CA)
- …corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. This includes medical , vision, dental, behavioral ... Specialty Health Plans Auditor III Claims Job...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Providence (CA)
- **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many states eligible.** **Providence caregivers are ... we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,… 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
- Dignity Health (Bakersfield, CA)
- …is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business ... **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the...related field **Where You'll Work** The purpose of Dignity Health Management Services Organization (Dignity Health MSO)… more
- NTT DATA North America (Ontario, CA)
- …when executed as part of an overall sourcing strategy. NTT DATA Services currently seeks Xcelys Medical Claims Team Lead to join our team remotely for a 3 month ... examiners, ensuring the accurate and timely processing of medical claims using the Xcelys system. The...medical , dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term… more
- Guidehouse (San Marcos, 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 of… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the ... technology and data to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth… more
- NTT DATA North America (Ontario, CA)
- NTT DATA is currently seeking **Senior Medical Claims Examiners (3+ years of Xcelys required)** to join our US based team. This is a 100% remote role. **Must be ... To serve as a senior-level adjudicator and SME for medical claims within the Xcelys environment. Provide...medical , dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term… more
- Humana (Sacramento, CA)
- …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health … more