- Cedars-Sinai (CA)
- …preceptor by mentoring PA's regarding care of defined populations in resource utilization and time management. + Demonstrate leadership as a clinical resource, ... + In partnership with department leadership provides organize, oversee, and review assigned daily work schedules, including patient load assignments. + Implements… more
- Sedgwick (Rancho Cordova, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. _As required… more
- Sedgwick (Orange, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state… more
- Banner Health (Susanville, CA)
- …management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission process ... a wide range of services. We provide a personalized medical approach and specialize in, general surgeries and orthopedics....Mia Frahry at ###@bannerhealth.com or call ### At Banner Medical Group, you'll have the opportunity to perform a… more
- Sedgwick (Sacramento, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state… more
- Abbott (Alameda, CA)
- …spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues ... accountability across business domains to support ethical and effective data utilization . **Demand/Intake Management** + Build deep relationships with our business… more
- Cognizant (Sacramento, CA)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... UB or HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered was medically appropriate… more
- Sharp HealthCare (San Diego, CA)
- …appeals and grievances. **Required Qualifications** + 3 years' experience in claims, utilization review , appeals or member services in a managed care ... and group agreements; Operations Manual; benefit matrices; and other administrative and medical guidelines, policies, and procedures. Works closely with the Chief … more
- Cardinal Health (Sacramento, CA)
- …+ Collaborate with facility EHR's to gather data to support diagnosis and medical clearances + Identify advocacy opportunities as it pertains to patient specific ... investigation as well as clinical clearance for prior authorization and medical necessity + Extensive patient education/counseling to determine eligibility for… more
- Stanford Health Care (Palo Alto, CA)
- …prior to or post services to identify government or charity programs to cover medical expenses. The position requires a patient financial interview which includes a ... review of hospital charges, the patient's insurance status and...various Patient Financial Clearance and Patient Access Services staff, medical center staff, physicians, guests, and patients regarding the… more