- Cedars-Sinai (CA)
- …people throughout Los Angeles and beyond. **Req ID** : 11588 **Working Title** : Claims Examiner - Managed Care **Department** : MNS Managed Care ... **Job Description** The Claims Examiner is responsible for accurately...is a leader in providing high-quality healthcare encompassing primary care , specialized medicine and research. Since 1902, Cedars-Sinai has… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and ... claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most...pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to… more
- WelbeHealth (Los Angeles, CA)
- …helps ensure excellent care delivery for our participants, and the Senior Claims Examiner plays a pivotal role in ensuring timely and efficient processing ... three (3) years of experience with processing, researching, and adjudicating claims in a complex managed care environment + In depth experience with Medicare… more
- Molina Healthcare (Detroit, MI)
- …or GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 1-3 years' experience in claims adjudication, Claims Examiner II, or other relevant work ... + Minimum of 1 year experience in healthcare insurance environment with Medicaid, or Managed Care + Strong verbal and written communication skills + Proficient… more
- Option Care Health (Bannockburn, IL)
- …compliance programs. + Direct experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines. + Proficiency with audit software ... no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and...large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance activities and… more
- Sedgwick (Knoxville, TN)
- …reports, claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care ; transfers payment allocations; and ... Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple...logins and the applicable security access for the company's claims management systems by determining the validity for incoming… more
- Molina Healthcare (Louisville, KY)
- …investigative and law enforcement procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as ... ASSOCIATION** : + Health Care Anti-Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all… more