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Requires broad training in fields such as business administration, accountancy, sales, finance/economics, computer sciences or similar vocations generally obtained through completion of a four year bachelor’s degree or equivalent work experience; Experience in retail pharmacy support, including knowledge in dealing with PBM claims processing, payment processing and reconciliation, preferred.
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Processing disability claims of minimal disability duration under close supervision. Industry Advancement Program | Workers Compensation Claims Representative Trainee | Orange, CA (In-Office.
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The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per diem, case rate etc.) Senior Claims Specialist must have knowledge of compliance issues as they relate to claims processing and ability to identify and address non-contracted providers.
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Reviewing and processing complicated workers' compensation claims. It is a great opportunity for the professional who has a minimum of 3 years of California Workers' Compensation Claims Representative experience and is looking for a 3-month plus work-from-home consulting opportunity.
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This position is expected to be highly collaborative by working closely with other departments such as the Claims, Intake, and Social Work teams to remedy any eligibility/enrollment issues. Initiate and maintain proper follow-ups with DHCS and CMS to ensure timely processing and completion of all mandated applications and accompanying documentation Maintain knowledge of eligibility and enrollment requirements for individuals participating in the Program of All-inclusive Care for the Elderly (PACE), including but not limited to out-of-area issues, Share of Costs (SOC), Primary Aid Codes, and excluded benefits.
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Train on claims processing procedures and systems. When you join the Auto Club as a Claims Representative, you're bringing your expertise to a best-in-class organization that is focused on delivering quality service to our members.
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Ideal candidates will possess claims processing/medical billing experience and a competitive desire to maximize returns. Experience with medical billing/claims processing.
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Typical duties include preparing, reviewing, and processing claims documents and forms; establishing and maintaining case files; utilizing automated case management tracking and filing systems, providing claims assistance to the various departments within the company, courts, jails, etc.
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Explain CARSTARs repair process, including insurance claims processing, payment procedures, repair techniques, repair needs and expected delivery date of repair. Educate customers on CARSTARs CSI/NPS survey (kept informed, customer service, quality of repair and on-time delivery.
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1 year of Experience in medical/institutional claims processing or enrollment processing. 1 year of Experience in medical/institutional claims processing or enrollment processing. CA Anaheim 200 W Center St Promenade.
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You will also coordinate the distribution of workers' comp claim documents to the insurance carriers to ensure timely and accurate processing of claims. When you partner with us, you're at the center of a vast network of experts who will help you reach your goals through risk services, claims management, and compliance support.
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Processes claims based upon contractual and/or CalOptima Health's agreements involving the use of established payment methodologies, Division of Financial Responsibility, applicable regulatory legislation, claim processing guidelines and company policies and procedures.
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The Associate Inventory Clerk is also responsible for filing these claims in the Inventory Room for First In, First Out (FIFO) retrieval. Performs duties in accordance with guidelines set forth in the Claims Industry to ensure compliance with AB1455 and departmental policy and procedures.
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Experience in retail pharmacy support, including knowledge in dealing with PBM claims processing, payment processing, and reconciliation preferred. Assist with accounting/reconciliation issues for customers and the processing of refunds to PBMs or billing recoveries from customers.
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The agent will assist clients in selecting and enrolling in suitable insurance plans, provide information on coverage options, assist with claims processing and resolve client inquiries.
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claims processing jobs in Anaheim, CA
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