- Ventura County (Ventura, CA)
- …are afforded a flexible credit allowance of up to $25,558 annually for purchasing medical , dental, and/or vision insurance from a group of authorized plans. + ... Flexible Spending Accounts: Pre-tax benefit towards eligible medical , dental, and vision care expenses. + Pension Plan:...(4) or more years' experience as a workers' compensation claims examiner or adjustor for an insurance … more
- Cognizant (Sacramento, CA)
- …assigned accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals , and retro-authorization as well as timely filing ... with Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims / appeals information on relevant tracking systems . Utilize critical… more
- Centene Corporation (Sacramento, CA)
- …to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex ... as to individuals and families served by the Health Insurance Marketplace. Looking for a compelling opportunity to move...cases and medical necessity appeals . + Participates in provider… more
- Sharp HealthCare (San Diego, CA)
- …with Medical Group Appeals on members with SNF services under appeals process.Reviews SNF claims for medical necessity and appropriateness when any ... medical information necessary for activities related to Medical Groups' Quality and Appeals processes. +...information on the claim is disputed and claims department is requesting verification. + Plan of careWorks… more
- Robert Half Accountemps (Los Angeles, CA)
- …handling medical denials and appeals . * Expertise in working with medical insurance claims and resolving discrepancies. * Ability to analyze account ... ideal for someone with expertise in medical billing, collections, and insurance processes. Responsibilities: * Review submitted claims to confirm accuracy… 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 ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Cardinal Health (Sacramento, CA)
- …billing queue as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and ... **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Dignity Health (Bakersfield, CA)
- …backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, appeals and grievances and other ... offices primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and… more
- Guidehouse (San Marcos, CA)
- …home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service + ... year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims...creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance +… more
- Stanford Health Care (Palo Alto, CA)
- …Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. ... Responding to requests from the payer, such as providing medical records or other documentation either by mail or...+ Reviewing and resolving payer rejections, denials, and performing appeals as necessary + Electronic or hardcopy claims… more