- Molina Healthcare (Long Beach, CA)
- …to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . + Manages a caseload of claims ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls...claim records. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in… more
- Kelly Services (Brea, CA)
- … Examiner? You'll be:** **Essential Duties and Responsibilities** + Analyzing and processing complex or litigated **California workers' compensation claims ** + ... isn't always easy. That's where we come in.** We're seeking a ** Claims Examiner - Workers' Compensation** to support a leading provider of technology-enabled… more
- Cedars-Sinai (CA)
- …Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We provide an amazing benefits package that includes ... Professional Fee billing and collections. Duties include reviewing and submitting claims to payors, performing account follow-up activities, updating information on… more
- Dignity Health (Rancho Cordova, CA)
- …codes to individual patient health information records for data retrieval analysis and claims processing . This position is expected to perform duties in ... State of California. Please check our website (https://www.commonspirit.careers/search-jobs) (Search Category: Medical Coding) for other remote or non- remote … more
- Mass Markets (CA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... POSITION OVERVIEW FULL-TIME REMOTE CUSTOMER SERVICE REPRESENTATIVE (SASKATCHEWAN) We are looking...to support inbound customer service, help desk, and back-office processing representatives for commercial and public sector support positions.… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …degree and 15+ years of experience in a FDA regulated pharmaceutical and/or medical device industry environment + Strong knowledge of current global Good Clinical ... arm. + Previous experience of working in the global pharmaceutical and medical device industry. + Experience working with external service providers. + Working… more
- Sharp HealthCare (San Diego, CA)
- …and group agreements; Operations Manual; benefit matrices; and other administrative and medical guidelines, policies, and procedures. Works closely with the Chief ... Medical Officer (CMO) who is responsible for all decisions...and grievances. **Required Qualifications** + 3 years' experience in claims , utilization review, appeals or member services in a… more
- Sharp HealthCare (San Diego, CA)
- …and group agreements; Operations Manual; benefit matrices; and other administrative and medical guidelines, policies, and procedures. Works closely with the Chief ... Medical Officer (CMO) who is responsible for all decisions...and grievances. **Required Qualifications** + 3 years' experience in claims , utilization review, appeals or member services in a… more
- Robert Half Accountemps (Lynwood, CA)
- …work opportunities may be available. Key Responsibilities: + Submit and process medical claims accurately to Medi-Cal, commercial insurance, government payers, ... with DMH-specific guidelines and payer regulations, ensuring accuracy in claims processing . + Prepare and analyze aging...medical billing with a focus on Medi-Cal and medical insurance collections. + Proven knowledge of claims… more
- NTT DATA North America (Merced, CA)
- …and experienced DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing . The ideal candidate will bring a strong understanding ... a DSNP Business Analyst to join our team in remote in the US. **Job Overview:** We are seeking...and maintain test plans with a focus on D-SNP-related claims processing scenarios. + Assess downstream implications… more