- Elevance Health (Costa Mesa, CA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment....term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Humana (Sacramento, CA)
- …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Sedgwick (San Diego, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Auto Appraiser **PRIMARY PURPOSE** **:** To inspect, identify, and evaluate ... directly with auto repair facilities to determinate supplemental repair processing and provides a supplemental estimate. **ADDITIONAL FUNCTIONS and… more
- Ventura County (Ventura, CA)
- …a flexible credit allowance of up to $25,558 annually to offset the purchase of medical , dental, and/or vision insurance for you and your dependents. + Employee ... biweekly pay period + Flexible Spending Accounts - Pre-tax benefit towards eligible medical , dental and vision care and/or dependent care expenses. + Pension Plan -… more
- Evolent (Sacramento, CA)
- …customer accounts + Strong knowledge of health plan operations, care/utilization management, claims processing , value-based care, and the levers to optimize ... Solutions, Strategic Accounts, Analytics, Client Finance, Implementation, Clinical Operations, Medical , Quality, and Call Center Teams) to identify new… more
- City and County of San Francisco (San Francisco, CA)
- …to the general duties above: + Detects, investigates, and prevents fraudulent claims for public assistance to avoid welfare fraud and other financial crimes. ... visits, often in situations requiring communication with individuals who may have medical (eg, drug or alcohol), psychiatric, or aggressive behavior problems, by… more
- Essel (Fairfield, CA)
- …and processing , employee record management, worker's comp and unemployment insurance management and claims processing Development, Implementation and ... processes and systems Assists with asset management, background checks, drug screens, medical exams and logistics for employees Ensures candidates meet all state and… more
- UIC Government Services and the Bowhead Family of Companies (San Diego, CA)
- …of Defense and many federal agencies. Bowhead offers competitive benefits including medical , dental, vision, life insurance , accidental death and dismemberment, ... required. + Extensive computer/PC knowledge required including; spreadsheet software, word processing software and knowledge of MS Office Suite. + Must be… more
- Maxim Healthcare (Monterey, CA)
- …with federal, state and local guidelines or regulations + Coordinates responses and processing of unemployment and workers' compensation claims + Responsible for ... company profit sharing, & weekly paychecks + Health, dental, vision, and life insurance + 401(k) savings plan with company matching + Employee discount program;… more
- Elevance Health (Los Angeles, CA)
- …**Preferred Skills, Capabilities, and Experiences:** + 3-5 years GBD Facets processing and adjustment experience strongly preferred. + Prior experience working with ... projects in various stages to completion strongly preferred. + Experience with medical billing guidelines, and regulations preferred. + Experience with medical … more