- 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
- 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
- Humana (Sacramento, CA)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with 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 ... **Responsibilities** The Claims Examiner III is an advanced-level role responsible...+ Expert knowledge of CPT, ICD-10, HCPCS coding, and medical terminology. + Associate's Degree - Associate's Degree in… more
- MGE Underground, Inc. (Paso Robles, CA)
- …| Performance | Trust | Fun How You Can Make an Impact The Safety, Health & Claims (SH&C) Coordinator is responsible for managing self-insurance and Workers' ... communication with internal teams and external stakeholders regarding safety, health , and claims -related matters. + Track and...skills, and applicable knowledge. Above and Beyond Benefits + Medical , dental, vision, and life insurance. + 401K +… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience with CPT-4, ICD-9CM, ... You can do all this and more at UCLA Health . The Claims Quality Auditor will be...medical terminology + Experience in benefit determination and claims adjudication + Ability to accurately key 6,000-8,000 keystrokes… more
- UCLA Health (Los Angeles, CA)
- …with: + High school diploma, GED or equivalent experience required + Minimum of 4 years medical claims payment experience in an HMO environment (ie MSO, IPA or ... You can do all this and more at UCLA Health . The Claims Quality Auditor serves as...understanding of Medicare Guidelines and COB required + Demonstrated medical terminology competence. + Working knowledge and experience in… more
- Royal Electric (Sacramento, CA)
- …with applicable state and federal regulations. + Coordinates with injured workers, medical providers, treating physicians, claims adjusters, Nurse Case Managers, ... claims paperwork to include incident reports, claim and medical status reports and related documentation. + Sets designated...time. We promote a drug free workplace. Benefits + Health Care Plan (3 types of Medical … more
- Providence (CA)
- …and retain the best people, we must empower them.** **Providence St Joseph Health operates a self-administered claims program for General and Healthcare ... Insurance terminology + Legal concepts + Liens + Electronic claims databases + Medical terminology **Skills required...including a retirement 401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life… more
- Illumination Foundation (Santa Ana, CA)
- …in Electronic Billing Platforms and EHR systems + Prior experience working with claims and communication with health networks + Proficiency in Microsoft (Mail, ... Angeles County and the Inland Empire. Job Description The Claims Specialist is responsible for accuracy of claims...Medical Insurance funded up to 91% by Illumination Health + Home (Kaiser and Blue Shield), depending on… more