• Facility Coding Inpatient DRG Quality

    Banner Health (CA)
    …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing ... focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate ** position, you bring your **5 years of acute care inpatient coding… more
    Banner Health (08/30/25)
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  • CM Area Manager

    Carollo Engineers (San Diego, CA)
    …$15 million + Critical Leadership position that requires project lead experience ** Preferred Qualifications** + Associate of Scienceor Bachelor of Science in ... development, client services and skilled in project controls systems, problem solving, claims avoidance **Pay Range** $170,000 to $220,000 annually. This is the… more
    Carollo Engineers (07/16/25)
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  • Senior Accounts Receivable Specialist (Meritain…

    CVS Health (Sacramento, CA)
    …monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** ... accounting system, including accounts receivable, accounts payable, auditing, and billing. ** Preferred Qualifications** + Resides in Amherst, New York, with the… more
    CVS Health (08/30/25)
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  • Customer Solution Center Appeals and Grievances…

    LA Care Health Plan (Los Angeles, CA)
    …medical necessity; benefit coverage appeals and reconsiderations, and complex provider claim disputes. The position is further responsible for tracking, trending and ... improvement Perform other duties as assigned. Duties Continued Education Required Associate 's Degree In lieu of degree, equivalent education and/or experience may… more
    LA Care Health Plan (08/26/25)
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  • Utilization Management Admissions Liaison RN II

    LA Care Health Plan (Los Angeles, CA)
    …(20%) Performs other duties as assigned. (10%) Duties Continued Education Required Associate 's Degree in Nursing Education Preferred Bachelor's Degree in Nursing ... management referrals (5%) Performs prospective, concurrent, post-service, and retrospective claim medical review processes. Utilizes clinical judgement, independent analysis,… more
    LA Care Health Plan (08/02/25)
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  • Market Facing Underwriter, Middle Markets

    Zurich NA (Los Angeles, CA)
    …work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while gaining ... and interpersonal skills to grow and develop relationships with preferred distribution partners in an assigned territory. This role...and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
    Zurich NA (08/15/25)
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  • Senior Management Liability Underwriter

    Zurich NA (San Francisco, CA)
    …School Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an ... Associate Degree and 3 or more years of experience...and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft… more
    Zurich NA (08/02/25)
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  • (USA) Area Manager Asset Protection - All DC/FC

    Walmart (Chino, CA)
    … qualifications for this position. If none are listed, there are no preferred qualifications._ 1 or More Degreed Certifications ( Associate Safety Professional; ... assigned area of work Creates action plans to address audit findings Validates claim records work with workers compensation case managers for investigation of … more
    Walmart (07/16/25)
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  • Negotiator Analyst (Level I)

    CVS Health (Sacramento, CA)
    …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the ... **Required Qualifications** + 3-5 years of experience in a medical claim background with understanding of benchmarking costs for medical services, supplies,… more
    CVS Health (08/27/25)
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  • Senior Process Improvement Professional

    Humana (Sacramento, CA)
    …and Lucid. ** Preferred Qualifications** + Minimum 1 year of experience medical claims payment and processing in a medical claim 's environment + Experience ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
    Humana (08/27/25)
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