- Travelers Insurance Company (West Hollywood, CA)
- …Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as ... is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim… more
- CDM Smith (San Diego, CA)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- Sharp HealthCare (San Diego, CA)
- …+ Assists in POS/PPO Case Management and high-cost review with CMO and Claims management teams. + Co-Chairs with the CMO CPTAC and Peer Review Committees. + ... needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'...management such as provider relations, member services, benefits and claims management, IT management, etc. + Plans, organizes, and… more
- Sharp HealthCare (San Diego, CA)
- …and oversees the health care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief Medical Officer. Is accountable for ... with medical management such as provider relations, member services, benefits and claims management, etc. Assists (as determined by the plan Chief Medical Officer)… more
- Dignity Health (San Bernardino, CA)
- …workplace. **Qualifications** + Two (2) years of recent experience as a Worker's Compensation Case Manager in a healthcare setting is preferred. + Knowledge of ... providers, and our third-party administrator. You will guide the claims process from start to finish-investigating work-related injuries, managing documentation,… more
- Abbott (Pleasanton, CA)
- …injured employees to reach maximum health and productivity. Functions as a clinical case manager and coordinates an individual client's health care services ... using data from various sources including, but not limited to aggregate case / claims experience, employer representatives, other health care providers, health… more
- LA Care Health Plan (Los Angeles, CA)
- …collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory ... within 2 hours of receipt; identify duplicate requests using the claims and verify existing authorization. Independently identifying and appropriately returning to… more
- CDM Smith (Rancho Cucamonga, CA)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- UCLA Health (Los Angeles, CA)
- Description Under the direction of the Workers' Compensation Analyst and department manager , you will manage workers' compensation claims by supporting employees ... treatment progress, recommending medical treatment interventions to the third-party claims examiner, and ensuring compliance with applicable workers' compensation… more
- Sacramento Municipal Utility District (Sacramento, CA)
- …type of inspection; and pre-assesses inspection projects with the Project Manager to determine level of inspection needed, checks environmental issues and ... and maintains job site records and progress reports; informs the Engineer/Project Manager on construction progress. + Various projects may be Distribution and… more