- Inland Empire Health Plan (Vallejo, CA)
- …the entire claim life cycle to ensure timely processing of claims based on regulatory and contractual compliance requirements.3. Oversight of all aspects of ... and to pivot from a "job" opportunity to an authentic experience!The Supervisor, Claims Processing - Medi-Cal provides daily oversight of claims staff, business… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- … Claims Oversight Auditor is responsible for ensuring the compliance of IEHP's claims payment system and processes by auditing claim payments using standard ... Functions (Duties and Responsibilities)1. Audit internal systems and controls to ensure the claims system is set up correctly and claims are processed in… more
- King's Seafood Company (Costa Mesa, CA)
- …protection and prevention.Manages audits and tracks all worker's compensation claims including all required forms and timelinesParticipates in quarterly reviews ... with TPA to ensure claims are being handled properly; takes appropriate action if neededResearches and analyzes data pertaining to any trends or patterns of… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …initiatives. Supports on-going analyses of financial, budgetary, or medical claims data, through forecasting, statistical analyses, trending, regression analyses, ... Responsibilities)1. Supports on-going analyses of financial, budgetary or medical claims data, through forecasting, statistical analyses, trending, regression analyses,… more
- Wraith Scarlett & Randolph (Vallejo, CA)
- …send correspondence on all new and renewal policies to the clientReport all new claims and manage ongoing claims as neededProcess policy cancellations and notify ... clientThoroughly document accounts using the agency's management systemMaintain working knowledge of crop insurance regulatory rules along with carrier regulations and policiesSkills and Specifications:Advanced knowledge of insurance companies and Crop… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …Responsibilities)1. Leads on-going analyses of financial, budgetary or medical claims data, through forecasting, statistical analyses, trending, regression analyses, ... risk assessment, and utilization assessment. Identifies key issues and trends and brings them to the attention of higher level staff members. Uses professional concepts and internal policies and procedures to solve problems or provide suggestions.2. Builds… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …action plans (CAPs) as needed to ensure compliance.5. Collaborate with the Claims Oversight Delegated team to share information from the financial audits and ... coordinate audit timing.6. Prepare quarterly financial viability reporting for all IPAs, medical groups, and/or delegated entities for the Delegation Oversight Committee.7. Monitor delegated entities' compliance with maintaining sufficient and active LOCs when… more
- Travelers Insurance Company (Diamond Bar, CA)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... moderate to complex Personal and Business Insurance Auto Damage claims as well as low complexity Bodily Injury Liability...include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) with… more
- Travelers Insurance Company (Irvine, CA)
- …appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of ... expertise to assist in the resolution of highly complex claims . Mentor other Claim Professionals + Participate in Telephonic and/or onsite File Reviews.… more
- Travelers Insurance Company (Sacramento, CA)
- …claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...any and all lines of business as needed. Handles claims and other functional work involving one or more… more
