- ICW Group (Pleasanton, CA)
- …to drive claims to an equitable resolution within Company standards. The Claims Specialist works with a sense of urgency, understands insurance coverage ... JOB** This role will be responsible for handling complex claims with a focus on providing exceptional service for...DUTIES AND RESPONSIBILITIES** Manages all aspects of a complex claims inventory in CA jurisdiction. + Effectively communicates with… more
- Adecco US, Inc. (Concord, CA)
- Join Adecco and discover an exciting career opportunity as a **Workers' Compensation Claims Processor** ! We are assisting a client in their search for a talented ... In this role, you will be responsible for processing claims , determining benefits, and ensuring timely resolution. You will...opportunities through the Adecco Aspire Academy + Dedicated onboarding specialist to guide you from offer to your first… more
- Defense Contract Management Agency (Fairfield, CA)
- …Conditions of Employment Qualifications To qualify for a Quality Assurance Specialist , your resume and supporting documentation must support: A. Specialized ... at the time of application) to support your educational claims . Or, if you are using education to qualify...at the time of application) to support your educational claims . The transcripts must include your name, the name… more
- Walgreens (Oakland, CA)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Marathon Petroleum Corporation (Martinez, CA)
- …and fosters a collaborative team environment. POSITION SUMMARY: The Loss Control Specialist will report directly to Loss Control & Quality Assurance Department's ... Loss Control West Manager. The Loss Control Specialist will support the refinery or refineries assigned, as well as nearby systems that affect inventory control, by… more
- Alameda Health System (Oakland, CA)
- Eligibility Specialist I + Oakland, CA + Finance + HGH Enrollment + Full Time - Day + Req #:40157-29608 + FTE:1 + Posted:Today **Summary** **Job Summary** : Under ... general supervision, the Eligibility Specialist I (ES I) performs a variety of hospital...prescribed timelines, to ensure timely and accurate submission of claims needed to maximize reimbursement to the Medical Center.… more
- Abbott (Livermore, CA)
- …serve people in more than 160 countries. **Job Title** **Insurance Data Management, Specialist III** **Working at Abbott** At Abbott, you can do work that matters, ... as the liaison between insurance companies, patients and the departments; + Ensure claims are processed and followed up to meet company goals of account receivable… more
- Essel (Fairfield, CA)
- …candidate will play a pivotal role in managing and defending against employment claims , particularly focusing on frivolous PAGA lawsuits, which are prevalent in our ... industry. + Lead the legal strategies in response to claims and other employment-related litigation. + Conduct thorough document reviews, searches, and production to… more
- Sutter Health (Antioch, CA)
- …imaging centers or other means (eg coordinating with reporting analyst using claims data) to ensure patient follow through on intervention and outreach efforts. ... * Supports the coordination of physician office staff education on P4P Outreach issues. * Prioritizes and reports concerns, improvements, and possible quality issues. * Maintains administrative statistical reports, department files, reference materials, and… more
- Abbott (Livermore, CA)
- …activities to ensure timely submission of primary, secondary and tertiary insurance claims . Serve as a subject matter expert. + Review and approve adjustments ... and claim appeal submitted by Specialist of Patient Accounts. + Conduct quality assurance reviews...software (such as XiFin, Telcor, Carevoyant, or Quad X), claims processing systems, Salesforce or other CRM system, Electronic… more
- Alameda Health System (Oakland, CA)
- …Coding Clinics, Medicare conditions of payments (NCD/LCDs), Medicare Benefits and Claims Manual; performs quality reviews on medical records by validating assignment ... AAPC Certified Professional Coder (CPC) or AHIMA's Certified Coding Specialist (CCS-P) or Certified Documentation Improvement Practitioner (CDIP). Alameda Health… more