- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... the Director. **Required Qualifications** + 5 Years in HMO or Health Insurance Management. + 2 Years leadership experience working collaboratively across multiple… more
- Robert Half Accountemps (Lynwood, CA)
- …and other medical billing software tools. Requirements * Proven experience in medical billing and claims processing. * Proficiency in using CareLogic and ... in the United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance . Hired… more
- Medtronic (Irvine, CA)
- …review of advertising and promotional material to ensure that it meets all medical , legal, and regulatory (MLR) process requirements. + Facilitate online and offline ... International promotional labeling material, including the creation of a claims matrix database and claims objects. +...communication, or a healthcare-related field + 4 years of medical device experience, including knowledge of the US and… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …change as determined by the needs of the business. BENEFITS for full time Employees + Medical , Dental, and Vision insurance + 401 (k) (available for Part Time & ... for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure… more
- Humana (Sacramento, CA)
- …in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary, Analytics/Forecasting ensures data integrity ... community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to… more
- Sedgwick (West Hills, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Leave of Absence Coordinator **Our teams connect! We collaborate onsite and have ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Sedgwick (Sacramento, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Marine Surveyor Sr **PRIMARY PURPOSE** : To inspect damaged cargo to determine ... collisions or motor failures. + Receives and reviews new claims and maintains data integrity in the claims...college or university preferred. Valid driver's license and current insurance coverage required, along with motor vehicle record that… more
- WestCare Foundation (Fresno, CA)
- …position ensures claims are submitted accurately and timely directly to insurance carriers and Medi-Cal Managed Care Plans (MCPs) in accordance with all DHCS, ... track CalAIM claims directly to Medi-Cal Managed Care Plans and insurance carriers. + Verify client eligibility, authorizations, and service coverage using payer… more
- CVS Health (Sacramento, CA)
- …Qualifications** + 2+ years of supervisory experience in healthcare reimbursement or medical insurance /billing + Clear understanding of how Collections and ... representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances,… more
- Highmark Health (Sacramento, CA)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more