- CVS Health (CA)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Kelly Services (Roseville, CA)
- …compensation claims by investigating and gathering information to determine claim exposure; managing claims through well-developed action plans to timely ... (onsite or remote). + Convenient Monday-Friday schedule, 8 working hours per day. + Competitive pay rate: **$49.07/hr** ....Calculating and paying benefits due; approving and making timely claim payments and adjustments; settling claims within… 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 ... further education as required. _California Only:_ California Workers' Compensation Claims Administration (WCCA) and Workers' Compensation Claim ...Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per… more
- Cognizant (Sacramento, CA)
- …regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing ... 6 weeks. This is a work-from-home position with day hours , and no travel is required. This position requires...information, and updating information to claim file about claims … more
- Guidehouse (San Marcos, CA)
- …+ Transmits or releases claims at a minimum daily. + Works all assigned claims daily by resolving edits, validating claim , or placing on departmental hold by ... billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the...Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required… more
- ICW Group (Woodland Hills, CA)
- …JOB** The purpose of this job is to supervise and provide guidance to the Claims Support staff and to assist in escalated Claims matters. This position exists ... to ensure that Company objectives and standards are met within the Claims Support team. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Manages a claims support unit… more
- NTT DATA North America (Ontario, CA)
- …EXPERIENCE + MINIMUM 7 YEARS CLAIMS EXPERIENCE + MUST WORK PST WEST COAST HOURS (8AM-5PM) About NTT DATA Services: NTT DATA Services is a recognized leader in IT ... sourcing strategy. NTT DATA Services currently seeks Xcelys Medical Claims Team Lead to join our team remotely for...Act as the first point of escalation for complex claim issues and provide expert assistance. + Conduct regular… more
- Conduent (Los Angeles, CA)
- …our client's pharmacy claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be required to represent our clients ... part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like to… more
- ICW Group (Pleasanton, CA)
- …a timely manner. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Provides administrative assistance to the Claims team. + Prints benefit and claim notices and prepares ... purpose of this job is to oversee administrative processes within the Claims department. This position exists to alleviate the administrative responsibilities of the… more
- ICW Group (Pleasanton, CA)
- …Learn more about why you want to be here! **PURPOSE OF THE JOB** The Senior Claims Examiner handles moderate to complex claims with a focus on providing the ... service for policyholders and ICW Group to independently bring claims to an equitable conclusion within Company standards and...Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per… more