Top 328 Finance systems Jobs in Fairfield, Ca

Claims Resolution Coordinator
Partnership HealthPlan of California —Fairfield, CA
- $37.22 - $46.53 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
Account Clerk I/II
City of Napa, CA —Napa, CA
- $63,240.46 - $82,520.24 a year
- Full-time
- Office
- Entry level
7d
Business Systems Analyst
Kinder's —Walnut Creek, CA
- $105,000 - $130,000 a year
- Hybrid work
- Mid-level
- Office
- Continuous improvement
- Health insurance
- 401(k)
Quick Apply
Sr. Client Service Associate/ Sr. Client Service Manager
Wealth Enhancement Group —Walnut Creek, CA
- $51,450 - $126,000 a year
- Full-time
- Hybrid work
- Research
- Mid-level
- Office
- Profit sharing
- Paid parental leave
3d
Applied Scientist - AI Trainer
DataAnnotation —Concord, CA
- $50.00 - $140.56 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
Simulation Engineer - AI Trainer
DataAnnotation —Oakville, CA
- $50.00 - $140.56 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
Senior Contracts & Claims Manager
TalentBurst, Inc. —Vacaville, CA
- $65 - $85 an hour
- Contract
- Bachelor of Science
- Research
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
4d
Sales Manager – Automotive Sales
Walnut Creek Honda —Walnut Creek, CA
- $100,000 - $250,000 a year
- Weekends as needed
- Dealership
- Merchandising
- Mid-level
- Paid training
- Health savings account
Quick Apply
Contract Manager
Lonza —Vacaville, CA
- Full-time
- Senior level
- Commercial
6d
Material Planner 2
Lonza —Vacaville, CA
- Full-time
- Oracle
- Mid-level
- Bachelor's degree
6d
Predictive Modeler - AI Trainer
DataAnnotation —California
- $70.78 - $141.56 an hour
- Part-time
- Remote
- Computer Science
- Writing skills
- English
- Flexible schedule
Quick Apply
Quantitative AI Evaluator - AI Trainer
DataAnnotation —California
- $70.78 - $141.56 an hour
- Part-time
- Remote
- Computer Science
- Writing skills
- English
- Flexible schedule
Quick Apply
Billing Specialist
Medic Ambulance Service —Fairfield, CA
- $21 - $25 an hour
- Online Application
- Word processing
- Writing skills
- Basic math
- Health insurance
- Dental insurance
Quick Apply
Plumbing Super Service Technician - Experience Required
Pearce Heating & Air Conditioning, Inc. —Winters, CA
- $30 - $40 an hour
- Full-time
- Background check
- Mid-level
- Residential
- Paid training
- Fuel card
Quick Apply
Director, Orthopedic Service Line
Northbay Healthcare —Vacaville, CA
- $195,000 - $205,000 a year
- Full-time
- Hybrid work
- Nursing
- 7 years
- Inpatient
- 403(b) matching
- Health insurance
Maintenance Technician III
Balfour Beatty —Fairfield, CA
- $37.09 an hour
- Full-time
- Carpentry
- Clean driving record
- Mid-level
- Disability insurance
- Health insurance
Recruiter
Robert Half —Crockett, CA
- $35 - $36 an hour
- Temporary
- Microsoft Outlook
- Mid-level
- 3 years
- Disability insurance
- Dental insurance
Quick Apply
4d
Sales Account Professional
Mariner Finance —Pleasant Hill, CA
- $20.65 - $26.85 an hour
- Full-time
- Spanish
- English
- Mid-level
Quick Apply
Senior Manager, Fiscal Services
CSU Chancellor's Office —California
- $110,000 - $125,000 a year
- Hybrid work
- Background check
- 3 years
- Finance
- Commuter assistance
- Health insurance
Consumer Loan Professional
Mariner Finance —Antioch, CA
- $19 - $25 an hour
- Full-time
- Spanish
- English
- Office
Quick Apply

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finance systems jobs near fairfield, ca

Claims Resolution Coordinator

Partnership HealthPlan of California -
Fairfield, CA

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Job Details

Full-time
$37.22 - $46.53 an hour

Qualifications

ICD-9
Driver's License
Typing

Full Job Description

Overview:

To research and resolve complex claims issues which cross interdepartmental lines and communicate the outcome to providers and affected Partnership managers. Develops and maintains provider training materials for all lines of business. Conducts provider trainings across Partnership departmental lines in group or individual provider settings.

Responsibilities:

Answers customer service lines as necessary and responds to provider inquiries either by phone, email, or in person regarding claims related questions.
Reviews, researches, and works with various departments to resolve complex provider inquiries, appeals, and grievances.
Acts as a resource and provides support to customer service staff, as well as Provider Relations staff for complex Provider questions regarding claims and payments.
Coordinates with Claims, Member Services, Health Services departments, the development, maintenance, and training of ongoing educational materials and tips for inclusion on the PHC website. Incorporates educational materials into the PR Manual and update on a quarterly basis.
Processes CIF's and adjustments as needed.
Writes and runs reports in Business Objects to obtain needed claim data.
Tracks and analyzes provider trends with denials and CIF's to provide support to providers with an opportunity to improve. Distributes provider scorecards.
Tracks complaints, appeals, and grievances by program. Reports activities on a quarterly basis to IQI, PHC Compliance Coordinator, and Claims Director.
Presents findings and recommendations for ongoing, long term resolutions to issues. Identifies items to address the “provider hassle factor.”
Acts as liaison and meets with designated staff from Claims, Health Services, Member Services, and QI departments to identify ongoing provider issues.
Coordinates system issues with Claims Configuration staff, IT staff, and PR Lead Project Specialist/Auditor. Leads or participates in special projects as needed.
Other duties as assigned

Qualifications:

Education and Experience

Minimum 1 year of experience in claims examining or customer service within healthcare, insurance, finance, or managed care environment; or equivalent combination of relevant experience and education.

Special Skills, Licenses and Certifications

Familiarity with Medi-Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD-9 diagnostic coding. Knowledge of Partnership Claim Policy and Procedures, Medi-Cal provider manual guidelines, Title 22 regulations and any other required policies, procedures, regulations, and manuals. Typing speed 30 wpm and proficient use of 10-key calculator. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business .

Performance Based Competencies

Ability to analyze and research claims issues. Excellent written and oral communication skills. Ability to present statistical and technical data in a clear and understandable manner. Good organization skills. Ability to work on multiple assignments simultaneously, prioritize work and complete projects within established time frames. Use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$ 37.22 - $ 46.53

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

finance systems jobs in fairfield, ca

Claims Resolution Coordinator

Account Clerk I/II

Business Systems Analyst

Sr. Client Service Associate/ Sr. Client Service Manager

Applied Scientist - AI Trainer

Simulation Engineer - AI Trainer

Senior Contracts & Claims Manager

Sales Manager – Automotive Sales

Contract Manager

Material Planner 2

Predictive Modeler - AI Trainer

Quantitative AI Evaluator - AI Trainer

Billing Specialist

Plumbing Super Service Technician - Experience Required

Director, Orthopedic Service Line

Maintenance Technician III

Recruiter

Sales Account Professional

Senior Manager, Fiscal Services

Consumer Loan Professional

I want to receive the latest job alert for finance systems in fairfield, ca

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