- Sharp HealthCare (San Diego, CA)
- …includes rationale for denial, potential appropriate alternatives, proposed member physician denial letter language. Pharmacy technicians are not authorized to ... and policies.Committee changes such as new or revised guidelines, drafting Benefit coding requests, and communication of changes to PBM vendor.Performs training for… more
- Sharp HealthCare (San Diego, CA)
- …the department. **Knowledge, Skills, and Abilities** + Working knowledge of hospital, physician and health care operations. + Demonstrates knowledge of on-line data ... rapidly changing deadlines. + Working knowledge of procedure, diagnostic, and revenue coding (eg, CPT-4, HCPCS, CRVS, RBRVS, RVS, ICD-9, etc.) and medical… more
- Adecco US, Inc. (Roseville, CA)
- …claimant and client. + Ensuring claim files are properly documented and claims coding is correct. + Processing complex lifetime medical and/or defined period medical ... claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. + Maintaining professional client… more
- UCLA Health (Los Angeles, CA)
- …perform a 12-lead EKG. + Knowledge and ability to set up and assist physician with any procedures such as, but not limited to audiometry, spirometry, O2 saturation ... change for cash payments. + General knowledge of medical terminology and ICD-10 coding + English/Spanish bilingual oral communication skills. + Ability to assist in… more
- Sedgwick (Brea, CA)
- …claimant and client. + Ensures claim files are properly documented and claims coding is correct. + May process low-level lifetime medical and/or defined period ... medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. + Maintains professional client… more
- Sutter Health (Burlingame, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager, Medical Social Worker and bedside RN to assure the ... levels of care and associated regulatory compliance requirements. General understanding of coding and DRG assignment process preferred. Must be able to effectively… more
- e CancerCare (Riverside, CA)
- …to patients and monitoring treatment plans. Respond to patient and referring physician needs and concerns regarding patient's treatment as expeditiously as possible. ... regulations, policies and procedures regarding medical record documentation and coding accuracy standards, established by the Company. Maintain values consistent… more
- Cardinal Health (Sacramento, CA)
- …including the insurance payers, specialty pharmacies, support organizations, and the patient/ physician to facilitate coverage and delivery of product in a timely ... and the Affordable Care Act preferred + Knowledge of Medical/Pharmacy billing and coding is preferred + Important to have a strong attention to detail **TRAINING… more
- Stanford Health Care (Palo Alto, CA)
- …may include reviewing prescription and diagnosis; acting as liaison with physician and supportive care personnel; preparing equipment, such as immobilization, ... records. + Displays a thorough understanding of radiation oncology billing and coding . Reviews treatment/ simulation documentation and billing on a daily basis for… more
- Sedgwick (Rancho Cordova, CA)
- …claimant and client. + Ensures claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical ... claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. + Maintains professional client… more