Claims Jobs in Fairfield
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Search Results - Claims Jobs in Fairfield
Fairfield
Overview:
Primary duty of the CSR III is to routinely process CIFs. They will be responsible to learn all CIF claim types within 18 months of accepting position.
Responsibilities:
• Research, resolve, and communicate outcome to providers on CIFs...
icims.com -
Essel-Fairfield
and processing, employee record management, worker's comp and unemployment insurance management and claims processing
Development, Implementation and oversight of HR initiatives, processes and systems
Assists with asset management, background checks, drug...
resume-library.com -
Fairfield
Overview:
To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Creates appropriate documentation that reflects the actions taken and status...
icims.com -
Cherry Talent Group-Fairfield
coverage is adequate and current. Coordinate with insurance providers to process claims and maintain necessary documentation.
Financial Reporting and Compliance: Prepare monthly financial statements, including balance sheets, income statements, and cash...
resume-library.com -
Fairfield
Overview:
The Sr. IT Manager of Enterprise Applications - Claims System will oversee and manage HRP Transaction Management functions effectively. This entails leading a team, prioritizing tasks, establishing and enforcing standards, training staff...
icims.com -
Fairfield
Overview:
Responsible for overseeing the Configuration and system changes for the claims adjudication
and case management systems. Responsible for maintenance and enhancement of system
configuration and related database tables, documentation...
icims.com -
Fairfield
provider contracts or State contract.
Identifies overpayments for recovery; researches and adjusts provider refund checks; identifies, verifies, and updates core claims system with members’ other health insurance coverage
information; and performs post...
icims.com -
Fairfield
benefit designs and ensure successful configuration, integration, and accurate and timely payment of claims and all PHC systems. Coordinates testing, quality assurance, configuration, installation, and support to ensure smooth, stable and timely...
icims.com -
Fairfield
Responsibilities:
• Conducts retrospective claims review, either in the aggregate or on an individual basis. Provides summaries of findings to the Team Manager UM.
• Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi...
icims.com -
Fairfield
Claims, PR, and Admin) in the areas of
operations, system enhancement & configuration, report generation, knowledge management, and training. This role involves maintaining a robust and secure UC environment, providing enduser support, and ensuring system...
icims.com -
Fairfield
Works with other departments to resolve claims, grievance, CC, PR, QI, RAC and member issues as necessary.
• Develops structures, relationships, and processes to promote active partnerships with providers, community stakeholders, and/or other healthcare...
icims.com -
Fairfield
Responsibilities:
• Conducts retrospective claims review, either in the aggregate or on an individual basis. Provides summaries of findings to the Team Manager UM.
• Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi...
icims.com -
Fairfield
Overview:
The Supervisor of Provider Systems will supervise the day-to-day operations of the Provider Relations (PR) Department functions involving provider data used for operations, reporting and claims processing. Provides supervision, support...
icims.com -
Fairfield
in Epidemiology, Public Health, or a closely related field; PhD, or DrPH preferred. 3-5
years of experience in applied epidemiology, preferably in a healthcare
claims database/EMR or public health setting.
Special Skills, Licenses and Certifications
Strong...
icims.com -
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