- Insight Global (Irvine, CA)
- …with strong understanding of medical terminology. Previous experience as a medical claims examiner or auditor preferred. Experience with claim investigation, ... An employer in the Irvine area is seeking a Claims Examiner II. This is a hybrid position, working...will assist management with implementation of measures to ensure claim processing and payment accuracy. They will also help… more
- CVS Health (Sacramento, CA)
- …and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. This person will also ... heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist** will review and adjust SF (...apply all cost containment measures to assist in the claim adjudication process. + Perform claim re-work… more
- Cognizant (Sacramento, CA)
- …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:** As Claims ... be responsible for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- Philadelphia Insurance Companies (Roseville, CA)
- …engaging training to Claim Division staff on best practices, good faith claims handling, and relevant developments in the law to promote effective and compliant ... 50 and rated A++ by AM Best. Position Overview Claim Counsel will provide legal counsel and strategic guidance...and strategic guidance regarding commercial property and casualty insurance claims . Reporting to VP of Claims &… more
- ICW Group (San Diego, CA)
- …best interest of all parties and providing benefits as prescribed by law. + Ensures claim files are properly documented and claims coding is correct. + Refers ... and further education as required. _California Only:_ California Workers' Compensation Claims Administration (WCCA) and Workers' Compensation Claim Professional… more
- Cognizant (Sacramento, CA)
- …a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims Processor** ... responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- Sedgwick (Riverside, CA)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead (Supervisor) Workers Compensation **PRIMARY PURPOSE:** To supervise the… more
- Centene Corporation (Sacramento, CA)
- …PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective claims ... a monthly, quarterly and annual basis to ensure regulatory compliance. + Perform claims compliance audits for either federal or state programs. + Evaluate processes… more
- Molina Healthcare (Long Beach, CA)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of ... claims . Ensures that claims are settled in...claims . Ensures that claims are settled in a timely fashion and in...of claimants. Keeps meticulous notes and records for each claim . + Manages a caseload of various types of… more
- Sedgwick (West Hills, CA)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | West Hills, CA Are you looking for an opportunity… more
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