- Providence (Anaheim, CA)
- **Description** Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Monitor check run process for ... accuracy. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative… more
- Carrington (Anaheim, CA)
- **Come join our amazing team and work remote from home!** The Default Claims Specialist is responsible for preparing, filing, and following up on all FHA, VA, ... USDA, PMI, and investor claims timely and accurately according to insurer/investor guidelines. Perform...phone conversations in the system notes. + Keep Team Lead and Supervisor informed of all trends and problems… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-20 **Position Title:** eCOB Specialist II **Job Description:** **eCOB Specialist II** **Location:** Hybrid, within 50 miles of ... Monday - Friday, 6am - 6pm EST The **eCOB Specialist II** is responsible for researching and investigating other...enrolling in Medicare. + Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well… more
- CROSSMARK (La Habra, CA)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **Qualifications** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Deloitte (Los Angeles, CA)
- Operations & Technology Transformation Specialist Master, Guidewire Data Migration - ETL Developer What we do Operations and Technology Transformation delivers ... on July 31, 2024 Work you'll do As an OTT Insurance Transformation Specialist Master, you will bring considerable technical expertise to deliver effective solutions… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-13 **Position Title:** eCOB Specialist I **Job Description:** **eCOB Specialist I** **Location** : Remote, within 50 miles of ... hours of 8 am - 4:30 pm The **eCOB Specialist I** is responsible for researching and investigating other...identify the correct formulas in order to adjudicates impacted claims , using multiple COB Formulas for the various product… more
- The County of Los Angeles (Los Angeles, CA)
- …CLASSIFICATION STANDARDS: Positions allocable to this class receive administrative and technical lead from a Chief, Environmental Health Specialist and may ... receive technical lead from an Environmental Health Specialist IV. Incumbents perform one of the following two...view correspondence. + Los Angeles County will not consider claims of not viewing or receiving notifications to be… more
- The County of Los Angeles (Los Angeles, CA)
- ENVIRONMENTAL HEALTH SPECIALIST IV Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3074682) Apply ENVIRONMENTAL HEALTH SPECIALIST IV ... No out-of-class experience will be accepted DEFINITION: Provides technical lead to Environmental Health Specialists III and Environmental Health Specialists… more
- Cedars-Sinai (Los Angeles, CA)
- …collections. Duties include but not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient ... (subject matter expert) to others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in other revenue cycle functions and… more
- Walgreens (Van Nuys, 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
- Cedars-Sinai (Torrance, CA)
- …Fee billing and collections. Duties include but not limited to, reviewing claims to payors, updating information on patient account, reviewing and processing ... others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in...and properly uses activity codes. + Accurately bills multispecialty claims within established timelines and initiates dialog with payors,… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-09 **Position Title:** Pharmacy Quality Assurance Specialist **Job Description:** **Pharmacy Quality Assurance Specialist ** ... office 1-2 days per week. The **Pharmacy Quality Assurance Specialist ** will be responsible for evaluating the quality of...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-30 **Position Title:** Legal Specialist II **Job Description:** **Location:** This position will take part in Elevance Health's ... with PulsePoint sites used for collaboration, community, and connection. The **Legal Specialist II** is responsible for providing legal support services for multiple… more
- Cedars-Sinai (Los Angeles, CA)
- …performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating ... others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in...**Req ID** : HRC1268782 **Working Title** : Revenue Cycle Specialist II **Department** : MNS PBS Huntington Hospital **Business… more
- Cedars-Sinai (Los Angeles, CA)
- …collections support, performing duties which may include reviewing and submitting claims to third party payors, performing account follow-up activities, updating ... others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in...**Req ID** : HRC1388706 **Working Title** : Revenue Cycle Specialist IV - Anesthesia **Department** : CSRC PB -… more
- Cedars-Sinai (Los Angeles, CA)
- …collections support, performing duties which may include reviewing and submitting claims to third party payors, performing account follow-up activities, updating ... others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in...**Req ID** : 1466 **Working Title** : Revenue Cycle Specialist IV **Department** : CSRC PB - Group **Business… more
- Cedars-Sinai (Torrance, CA)
- …performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating ... others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in...**Req ID** : 1640 **Working Title** : Revenue Cycle Specialist II **Department** : CSRC PB - Group **Business… more
- Elevance Health (Woodland Hills, CA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... HS diploma or equivalent and a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- The County of Los Angeles (Los Angeles, CA)
- …Advises Environmental Health Specialists I on meeting Environmental Health Specialist II registration requirements. Requirements MINIMUM REQUIREMENTS: Four years' ... experience as a Registered Environmental Health Specialist , two years of which must have been at...and investigations of complex environmental health problems; or provides lead supervision to field staff who are enforcing environmental… more
- MetroLink (Los Angeles, CA)
- …Incumbent possesses considerable latitude to accomplish tasks, which may include lead worker or supervisor duties. SUPERVISION EXERCISED AND RECEIVED + Receive ... Management. + This position has no formal supervisory responsibilities; may lead the work of lower-level staff. ESSENTIAL DUTIES AND RESPONSIBILITIES The… more