Claims Processing Jobs in California (NOW HIRING)

Process and review insurance claims for accuracy and completeness. * Communicate with healthcare providers and insurance companies to resolve claim issues. * Maintain detailed records of claims ...

... processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through ...

About the role Under management direction, responsible for reviewing and processing all types of medical and facility claims from contracting and non-contracting providers and from subscribers and ...

They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for ...

Claims Auditor will be responsible for auditing claims processed by Claims Examiners. Responsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT ...

Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and electronic claims per state, federal, and health plan regulatory requirements and department guidelines, as ...

Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. Seeks to improve overall claims performance, and ensure claims ...

Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claims recovery (refund request letters, refund checks, claims reversals), and ...

Leverages deep understanding of medical claims processing, analytical skills, root-cause analysis, and regulatory interpretation to effectively triage issues to facilitate complex/high priority ...

Leverages deep understanding of medical claims processing, analytical skills, root-cause analysis, and regulatory interpretation to effectively triage issues to facilitate complex/high priority ...

Required Qualifications Must have at least 2 years of experience processing Medicaid claims At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably ...

Required Qualifications At least 1 year of claims processing experience in a managed care setting, or equivalent combination of relevant education and experience. Data entry and research skills.

Required Qualifications Must have at least 2 years of experience processing Medicaid claims At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably ...

Required Qualifications • Must have at least 2 years of experience processing Medicaid claims • At least 1 year of experience in a clerical role in a claims, and/or customer service setting ...

Leverages deep understanding of medical claims processing, analytical skills, root-cause analysis, and regulatory interpretation to effectively triage issues to facilitate complex/high priority ...

Claim analyst is responsible for the end to end process for any configuration and automation projects Functions & Job Responsibilities · Includes claims systems utilization, capacity analyses ...

Identify processing errors and make corrections prior to the weekly FFS payment cycle. * Identify claims payment errors and perform claims revision/correct activities for repayment or deduction per ...

Must serve as a back up to claims processing when needed to ensure the department turn-around times are met and maintain inventory within 21 days on hand. Responsible for prompt communication with ...

Identify processing errors and make corrections prior to the weekly FFS payment cycle. * Identify claims payment errors and perform claims revision/correct activities for repayment or deduction per ...

Identify processing errors and make corrections prior to the weekly FFS payment cycle. * Identify claims payment errors and perform claims revision/correct activities for repayment or deduction per ...