- Cardinal Health (Sacramento, CA)
- …Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off ... Legal function. **_Job Summary_** The Assistant General Counsel, Nuclear & Precision Health Solutions (NPHS) is responsible for providing outstanding legal advice to… more
- Elevance Health (Walnut Creek, CA)
- **Title:** Behavioral Health Provider Quality Manager **Candidates must posses a licensure for the state of California.** **Location:** This role enables associates ... to the field as needed in** **Northern California.** **Schedule:** Pacific Standard Time Carelon Health is a proud member of the Elevance Health family of… more
- Elevance Health (Costa Mesa, CA)
- …to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to ... + Demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, the company's internal business… more
- Sharp HealthCare (San Diego, CA)
- …improve quality, and reduce costs. + Internal and External Customer ServiceInterface with Health Plans, Providers, Members, Medical Groups and Internal Sharp ... and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit… more
- Elevance Health (Walnut Creek, CA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,...or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information… more
- Travelers Insurance Company (Diamond Bar, CA)
- … with lost time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a ... Medical Case Manager. Independently handles assigned claims ...handling experience **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more
- Sharp HealthCare (San Diego, CA)
- …improve quality, and reduce costs. + Internal and External Customer ServiceInterface with Health Plans, Providers, Members, Medical Groups and Internal Sharp ... investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or … more
- LA Care Health Plan (Los Angeles, CA)
- …Experience Required: At least 5 years of experience in Systems Configuration; Claims and Health Services/Population Health department. Advanced knowledge ... health plan quality assurance (especially related to claims , health services/population health as...with a California Medi-Cal managed care plan or Commercial health plan, medical group, or management services… more
- J&J Family of Companies (Irvine, CA)
- …but not limited to R&D, Clinical Research, Regulatory Affairs, Quality & Compliance, Health Economics & Market Access, and Professional Medical Education to ... At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation... for humanity. Learn more at https://www.jnj.com **Job Function:** Medical Affairs Group **Job Sub** **Function:** Medical … more
- Towne Park (Santa Monica, CA)
- …the policy guidelines. **Benefits:** Employees are eligible to enroll in medical , dental, and vision insurance, accident insurance, critical illness insurance, ... the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover + Manages scheduling, overtime for associates… more