- CDM Smith (Carlsbad, CA)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Identify contractual requirements to maintain and prosecute claims , and assist project team in managing to those...to do so. Where it's a priority that the company takes good care of you and your family.… more
- Sedgwick (Sacramento, CA)
- …and organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. + Celebrate your career ... support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues… more
- CTG (CA)
- …module for Ambulatory and Behavioral Health settings. + Design and build claims logic, charge capture workflows, fee schedules, charge routers, billing rules, and ... changes and upgrades. + Analyze and resolve issues related to charging, claims , remittance, and billing workflows. + Support go-live and post-live stabilization… more
- The Hartford (Brea, CA)
- …We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... business environment where you will have direct interaction with Claim partners and insureds, we want to speak with...of defense strategies with autonomy. * Partner with our Claims Partners to achieve the best results for our… more
- CVS Health (CA)
- …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... will be responsible for making both pre and post-payment claim payment determinations based on Aetna Clinical Policy and/or...Responsible for peer to peer reviews of SIU related claims based on provider escalation or state/federal requirements +… more
- Philadelphia Insurance Companies (Pasadena, CA)
- …staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. We work ... TMA + Work closely with other internal departments such as loss control, claims , coordination, premium audit, and accounting to meet client service goals and… more
- Cedars-Sinai (Los Angeles, CA)
- …assigned work queues accounts and completes account follow-up activities including: obtaining claim status, responds to insurance company and other authorized ... Los Angeles. We also were awarded the Advisory Board Company 's Workplace of the Year. We provide an outstanding...insurance carriers. + Analyzes and validates reimbursement for denied claims . Accurately and consistently document the results of all… more
- Robert Half Legal (San Francisco, CA)
- …compliance and mitigate potential risks. * Handle documentation and resolution of claims related to delays, equitable adjustments, design defects, and change orders. ... and construction defects. * Manage legal strategies for dispute avoidance and claim preparation to protect client interests. * Conduct legal research and analysis… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …Accurately document benefit verification results in pharmacy systems. . Troubleshoot rejected claims and perform necessary claim adjustments. . Assist in ... of prior authorization routing and third-party review processes. . Experience with claim troubleshooting and payer override procedures. . Strong verbal and written… more
- Robert Half Legal (Walnut Creek, CA)
- …calendars and schedule meetings, court dates, and other important events. * Administer claims and handle all aspects of complaint resolution. * Utilize Adobe Acrobat ... with Calendar Management for scheduling appointments and deadlines. * Skilled in Claim Administration, including claim filing and follow-up. * Strong ability… more