- City and County of San Francisco (San Francisco, CA)
- … claims processing, and/or collecting healthcare service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare , insurance , third party ... Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this...issues; + Performs revenue analysis related to charge errors, claims submission volume, denials and trends based on claim… more
- University of Southern California (Arcadia, CA)
- …within the institution. + It is the responsibility of the Patient Access Representative to uphold the highest service standards regarding patient care. + Making ... and compliant with HIPAA, EMTALA, the Fair Debt and Collection Practices Act, Medicare Secondary Payer, and other laws and regulations that govern Patient Financial… 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
- Allied Universal (Stockton, CA)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …billing, health insurance , or specialty pharmacy. . Familiarity with commercial insurance , Medicare , Medicaid, and specialty drug coverage. . Knowledge of Rx ... access to specialty medications. This role is essential in verifying insurance coverage, identifying payer requirements, and facilitating prior authorizations. The… more
- Highmark Health (Sacramento, CA)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a… more