- Sedgwick (Glendale, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Representative | Glendale, CA (In-Office) ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Travelers Insurance Company (Rancho Cordova, CA)
- …**What Is the Opportunity?** Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
- Travelers Insurance Company (Walnut Creek, CA)
- …under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and ... Claim team is committed to partnering with our business insurance customers to help their injured employees return to...you will handle all aspects of a workers compensation claims . In this role, you will learn how to… more
- Surgery Care Affiliates (Long Beach, CA)
- …for Primary insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or ... guidelines and the process of collecting over the counter payments/deductibles/copay/co- insurance . Knowledge of payer contracts including Medicare , Medicaid… more
- Cardinal Health (Sacramento, CA)
- …the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Stanford Health Care (Palo Alto, CA)
- … Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The ... rejections, denials, and performing appeals as necessary + Electronic or hardcopy claims editing and submission to payers + Recognizing potential trends and… more
- Fresenius Medical Center (Pittsburg, CA)
- …coordinate insurance options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal ... and annual indigent waivers. + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid ... is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial… more
- Humana (Sacramento, CA)
- …- What it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with ... experience directly managing a group of seasoned professionals. + Proven knowledge in Medicare regulations + Excellent PC skills MS Excel and Access and PowerPoint… more
- The County of Los Angeles (Los Angeles, CA)
- …new or revised procedures. + Works with Professional Standards Review Organization representative to orient new staff to Federal laws and regulations pertaining to ... Medicare and Medi-Cal reimbursement. + Analyzes cases for referral...provided to patients are appropriate and covered by the insurance payer. They are responsible for ensuring that patient… more