- CVS Health (Sacramento, CA)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... _fully insured_ ), Reinsurance, and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing… more
- City and County of San Francisco (San Francisco, CA)
- …may perform the following duties: QUALITY CONTROL, INVESTIGATIONS, OVERPAYMENTS, AND/OR APPEALS SPECIALIST Under general supervision, the Quality Control, ... resources, and presentation media. + Facilitates and contributes to short and long-term projects and workgroups. + Provides technical...Investigations, Overpayments or Appeals Specialist performs investigations in support of… more
- CVS Health (Sacramento, CA)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Cedars-Sinai (Los Angeles, CA)
- …daily reconciliation, processing payment transfers, reviewing and submitting claims to payors, performing account follow-up activities, updating information ... and resolve complex cases and problem accounts with minimal assistance. Submits appeals and collect monies relative to physician reimbursement. Services as a… more
- Cardinal Health (Sacramento, CA)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure...day with myFlexPay + Flexible spending accounts (FSAs) + Short - and long-term disability coverage + Work-Life resources +… more