- Cedars-Sinai (CA)
- …people throughout Los Angeles and beyond. **Req ID** : 4955 **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
- Sedgwick (Frankfort, KY)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner **PRIMARY PURPOSE** **:** To analyze complex or technically ... including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact....care organization and appropriate medical contact. + Ensures claims files are properly documented and claims … more
- Molina Healthcare (St. Petersburg, FL)
- …level position where you have the opportunity for growth & advancement. As a Claims Examiner , you will be responsible for administering claims payments, ... **Molina Healthcare of Florida** is hiring for several Claims Examiners. These positions are remote; however, all...Claim, Appeals and Grievances, Data, Follow Up, Medicaid, Medicare, Managed Care , MCO, Codes, Processor, HMO, Bill,… more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals ... **Preferred Qualifications:** + Six (6) months experience as a Claims Examiner preferred. Completion of vocational school...preferred. + Experience in medical billing services and/or a managed care environment preferred. + Knowledge of… more
- Molina Healthcare (Fort Lauderdale, FL)
- …Denial and Claim, Appeals and Grievances, Data, Follow Up, Medicaid, Medicare, Managed Care , MCO, Codes, Processor, HMO, Bill, Adjust, Healthcare, Health ... **Molina Healthcare of Florida** is hiring for several Sr. Claims Examiners. These roles remote, however **candidates must reside in Florida.** Ideal candidates will… more
- Health Advocates Network (Folsom, CA)
- …+ Minimum of two (2) years of Professional Billing with an emphasis on Managed Care denial follow-up and appeals processing - prior hospital billing experience ... as a general knowledge of Commercial, HMO, and Medicare Advantage claims , authorization, and documentation requirements. + Proficient in computer skills including… more
- LA Care Health Plan (Los Angeles, CA)
- …Plan claims of a complex nature. Extensive experience working with COB and TPL claims in a managed care setting. Must be highly experienced in ... documents are current and meet the requirements of LA Care . Claims examiners and auditors are utilizing...to track and trend the metrics associated with the examiner and auditor production and prepare and present written… more
- LA Care Health Plan (Los Angeles, CA)
- …Required: At least 6 months of accurate, high-volume claims data entry or claims processing experience. Preferred: Managed care or Medi-Cal claims ... communication skills Licenses/Certifications Required Licenses/Certifications Preferred Required Training Preferred: Claims Examiner Training Physical Requirements Light Additional… more
- Molina Healthcare (New York, NY)
- …lieu of education experience) + At least five (5) years' experience working in a Managed Care Organization or health insurance company + Minimum of two (2) ... investigative and law enforcement procedures with emphasis on fraud investigations + Knowledge of Managed Care and the Medicaid and Medicare programs as well as… more
- Sedgwick (Knoxville, TN)
- …reports, claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care ; transfers payment allocations; and ... Taking care of people is at the heart of...78758.** **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple… more